Christina Dawn Monroe
What babywearing has meant to Lennox this our journey:
Lennox is 11 months old. He came into my care at 6 months of age. He is exclusively breastfed; his mom was the only one to ever put him to sleep. He is a boob man, for bed time. I was also warned he was not a stroller fan.
I have worked in the childcare field for 15 years (have a degree in early childhood education). As I just recently went back to having a day home. I had not owned a carrier for years. I ordered a babyhawk with my first pay check from Lennox’s parents. Then we waited a further 2 weeks for it to arrive. For one whole month we were carrierless. It was a pretty shitty month.
We had the challenge of dealing with transitioning to reverse cycle breast feeding. You see Lennox does not like bottles (regardless of how many different kinds I tried) and the same went for sippy cups. For liquids we went to feeding with a spoon and mom coming to feed at lunch if needed. Then there was the whole I do not sleep without a breast thank you. Apparently dad had never had any luck either. Did not matter that I walked around with him, he was not left alone to cry. He was only going to sleep because he screamed himself out. Then there was the strollers 3 different kinds. He screamed even louder, with summers so short here we had to go out regardless of the yelling.
The day the package came is the day everything went up hill. It changed everything for the better.
I opened my pretty package and strapped him in and he just relaxed. He was calm for the first time in a month. He quickly learned to sign for his carrier if he needed to be up instead of on the floor exploring. If he needed to be closer to me. We figured out that if we are close and feel safe we can fall right to sleep. He kind of just gives a sigh and passes out. I can then transfer him to a mat or keep in there if we are out. We learned by watching closely that straws are cool (I have an addiction to iced lattes) He would watch me intently, so focused as it is so close to his face. We got him a litter-less juice box and away we went! He snuggles the juice box full of breast milk right between my breasts and drinks it all down! No more spoon feeding milk! We no longer have to use a stroller to go out so we can go many more places; he has a bird’s eye view. We can climb rocks and he can see! He can choose not to wear mittens and be inside my coat instead! Life is wonderful.
Mom thought this was cool borrowed my carrier then ordered herself her very own. Now dad can put him to sleep too!
Babywearing has made Lennox into a much happier little person.
Thursday, October 7, 2010
Friday, October 1, 2010
Wearing My Son Through His Withdrawal
by Stacey Freeman
I am a mom of 5 and foster mom to 3, and huge fan of baby wearing!! My foster baby was dropped off at 10 days old extremely small, sick looking and going through withdrawal. At the same time he was arched backwards and impossible to hold he would just scream. After the first horrible night I went and dug through all by baby boxes in desperate need of my sling (he had been dropped off with only half hour notice, so I had no baby supplies handy. Honestly within 5 minutes he was asleep and content!! For the next 3 weeks he lived in that sling until the withdrawal symptoms had passed only coming out for diaper changes. I slept sitting up on the couch with him snuggled against my chest even.
I am adopting this baby now and he is the most precious happy little boy. I am SO thankful I had that sling!!
I am a mom of 5 and foster mom to 3, and huge fan of baby wearing!! My foster baby was dropped off at 10 days old extremely small, sick looking and going through withdrawal. At the same time he was arched backwards and impossible to hold he would just scream. After the first horrible night I went and dug through all by baby boxes in desperate need of my sling (he had been dropped off with only half hour notice, so I had no baby supplies handy. Honestly within 5 minutes he was asleep and content!! For the next 3 weeks he lived in that sling until the withdrawal symptoms had passed only coming out for diaper changes. I slept sitting up on the couch with him snuggled against my chest even.
I am adopting this baby now and he is the most precious happy little boy. I am SO thankful I had that sling!!
Wednesday, September 8, 2010
On Consent
Vyky Staples
(professional body piercer and fierce mama)
Informed consent is something I see discussed ad infinitum on blogs, message boards and in print in magazines. Informed consent is a powerful tool to have in our journeys as Fierce Mamas- being able to make an educated decision in regards to our health and wellbeing and the health and wellbeing of our babies. We are their advocates, and it's a duty I hold with utmost importance. We choose for our babies who are not able and ready to choose for themselves.
I want to share with you an event I experienced recently that radically shook me and cemented my beliefs. I was shopping. Seeking retail therapy, actually, as a way to relieve myself of some pent-up stress and to soften the blow of leaving my baby in the care of someone else as I am enrolled in school. My shopping trip was winding down, and I was making my way to the food court to grab a coffee to enjoy on the way home. I was approaching a jewelry store and as I neared it, I witnessed something that made my heart jump into my throat.
A very young baby, I'd guess to be around 3 months old, thrashing and screaming as her mother held her arms with one arm and immobilized her head with the other as a store employee was piercing her earlobes. I noticed the mother herself had tears in her eyes.
I was absolutely shocked and appalled. The whole scene had reduced me to tears, an I quickly had to flee the building where I sat in my car and sobbed over what I had just seen. I couldn't make sense of why the mother of that poor baby would subject her to such a thing. She was clearly acting against her maternal instincts- she herself was in tears- she knew what she was doing to her child was wrong.
Yes- WRONG.
It is absolutely, without a doubt wrong to modify the body of a person unable to consent- whether it be female genital mutilation, male circumcision or piercing the earlobes of a young girl. When a child or baby is unable to make informed consent, you are violating their bodies and you are violating their trust. Children are vulnerable and inherently rely on their parents to make decisions on their behalf. And by making permanent changes to their bodies when they are unable to understand the risks, the procedure, the aftercare and the permanent affects, you are revoking their right to choose for themselves.
Furthermore, the stress respond to the stimulus in question can have devastating effects on the infant. When put under extreme duress, the hypothalamus excretes cortisol. When the brain excretes large amounts of cortisol or is forced to excrete it chronically (such as when a parent allows the child to "cry it out"), it can increase the risk of SIDS, and can, in the long term, affect the memory, attention, and emotional wellbeing of the child. Studies also suggest that this can manifest in adulthood into anxiety and depressive disorders.
This brings me to the question of why anyone would subject their child to such a procedure? Is it that important that complete strangers that you'll never speak to or see again know the sex of your baby? Children are not born with a sense of vanity- that is instilled in them by their surroundings as they grow. Baby girls have no need for bedazzled earlobes- they have a need for parents she can trust unconditionally to make sound decisions on her behalf until she is able to utilize informed consent of her own accord.
(professional body piercer and fierce mama)
Informed consent is something I see discussed ad infinitum on blogs, message boards and in print in magazines. Informed consent is a powerful tool to have in our journeys as Fierce Mamas- being able to make an educated decision in regards to our health and wellbeing and the health and wellbeing of our babies. We are their advocates, and it's a duty I hold with utmost importance. We choose for our babies who are not able and ready to choose for themselves.
I want to share with you an event I experienced recently that radically shook me and cemented my beliefs. I was shopping. Seeking retail therapy, actually, as a way to relieve myself of some pent-up stress and to soften the blow of leaving my baby in the care of someone else as I am enrolled in school. My shopping trip was winding down, and I was making my way to the food court to grab a coffee to enjoy on the way home. I was approaching a jewelry store and as I neared it, I witnessed something that made my heart jump into my throat.
A very young baby, I'd guess to be around 3 months old, thrashing and screaming as her mother held her arms with one arm and immobilized her head with the other as a store employee was piercing her earlobes. I noticed the mother herself had tears in her eyes.
I was absolutely shocked and appalled. The whole scene had reduced me to tears, an I quickly had to flee the building where I sat in my car and sobbed over what I had just seen. I couldn't make sense of why the mother of that poor baby would subject her to such a thing. She was clearly acting against her maternal instincts- she herself was in tears- she knew what she was doing to her child was wrong.
Yes- WRONG.
It is absolutely, without a doubt wrong to modify the body of a person unable to consent- whether it be female genital mutilation, male circumcision or piercing the earlobes of a young girl. When a child or baby is unable to make informed consent, you are violating their bodies and you are violating their trust. Children are vulnerable and inherently rely on their parents to make decisions on their behalf. And by making permanent changes to their bodies when they are unable to understand the risks, the procedure, the aftercare and the permanent affects, you are revoking their right to choose for themselves.
Furthermore, the stress respond to the stimulus in question can have devastating effects on the infant. When put under extreme duress, the hypothalamus excretes cortisol. When the brain excretes large amounts of cortisol or is forced to excrete it chronically (such as when a parent allows the child to "cry it out"), it can increase the risk of SIDS, and can, in the long term, affect the memory, attention, and emotional wellbeing of the child. Studies also suggest that this can manifest in adulthood into anxiety and depressive disorders.
This brings me to the question of why anyone would subject their child to such a procedure? Is it that important that complete strangers that you'll never speak to or see again know the sex of your baby? Children are not born with a sense of vanity- that is instilled in them by their surroundings as they grow. Baby girls have no need for bedazzled earlobes- they have a need for parents she can trust unconditionally to make sound decisions on her behalf until she is able to utilize informed consent of her own accord.
To Induce or Not to Induce?
Tegan Vanden Bosch
It was my ten-week pregnancy check up. Being the nervous new-to-be mother, I had a lot of questions for my OB when I went to my appointment. One of many questions asked, and answered, was as follows:
“So at what point in the pregnancy do we start talking about the labor and delivery process?” I was just curious, I looking for answer akin to “Oh, about 30 or 35 weeks”. I’m a planner; I just wanted a time-line for myself to mentally prepare for every step in the pregnancy and birthing process. Instead I got something quite different.
“Well, we’ll probably induce you at thirty-eight weeks, most likely on a Thursday.”
What?!? Induction? What in the world for??? “I don’t really believe in being induced for a non-medically necessary reason . . .” I started timidly, completely taken for surprise. I hadn’t really been prepared to defend myself in such a manner at this point in my pregnancy.
In a very brisk, business-like manner, the doctor replied “It really is best, that way your husband will know ahead of time and can get off work (she nodded her head to my husband who was sitting in the chair next to the exam table), you’ll be able to get a full night’s rest before the baby comes . . .” and she continued to rattle off another half dozen or so reasons of why she wanted to induce me.
I couldn’t believe it, and at the same time that I was forming an argument in my head for every single reason, I felt powerless to respond. I felt as though my beliefs had just been trampled upon. From previous visits and conversations with this doctor, I knew that she and I stood on the same ground on many issues including contraception, natural family planning and God’s presence in the entire process of marital bliss, including conception. And here she was telling me she was going to induce me? I was only ten weeks pregnant; I wasn’t carrying twins, I didn’t have two uteruses or a uterus with a septum, I didn’t have any reason for being high risk and needing to have my labor induced. This OB had delivered three of my good friend’s babies and they all were able to have completely natural labors (without ever mentioning induction). Why did she suddenly say she wanted to induce me? Why didn’t she listen to what I wanted to say about being induced? Aren’t I the one who will have to carry and birth this baby and live with the choices and decisions and consequent life long memories, not her? I left her office that day stunned, disappointed, ignored and bewildered. I knew that I had a lot to think about.
My attributing factor to this news was that she had recently moved into a solo practice, away from a group practice. In a group practice, an OB is freed from being on call twenty-four/seven; an OB in solo practice doesn’t have that luxury. So for strictly business reasons of pure convenience, it is not unusual for an OB in solo practice to try to schedule as many inductions as possible, whether they are medically necessary or not.
I am not saying I am against inducing women into labor; there are certainly a number of reasons where a woman should be induced for her safety and/or the safety of her child. For example, preeclampsia or eclampsia (where the mother’s blood pressure is extremely high due to the baby), if the baby has had their first bowel movement prior to the water breaking and/or prior to being born, being two weeks past the due date (greater than 42 weeks), and the list of reasons goes on. For the purpose of this paper, I would like to explore medical induction of labor and the reasons for and against doing so. Personally, I think that a healthy baby being born to a healthy mother should be able to arrive in their own time and that the convenience of the mother, or especially the doctor, should not come into play at all.
Therefore, to be induced, or not to be induced, that is the question. The answer, ultimately, will depend on the beliefs of the mother, the beliefs of the doctor, and hopefully foremost, the health of the baby and the mother evaluated together. Technology has progressed a long way in our society, which has given many babies a chance at life whereas before the technology existed, they, and mostly likely the mother as well, might have died in labor. Unfortunately our society has taken that technology and used it for a purpose that is not its original intent: personal convenience.
According to Wilson, the onset of labor, once considered a naturally occurring event, has become one of timing, control, and convenience for both obstetrical providers and expectant women, with nearly two thirds of all labor induction in the US now initiated for non-medical reasons (208). Is this the best practice for the baby and the mother? The induction of labor for non-medically necessary reasons is one of the most controversial issues in maternity care in this country today (Amis 16). The National Center for Health Statistics wrote that in 2002, the rate of labor induction in the United States had a 129% increase from 1989, the first year that data on induction was collected (Simpson and Thorman, 135). Wilson writes that because labor induction is a relative new event, data collection was not routinely collected for induction until 1989 (208).
In the last few weeks of pregnancy, the mother’s body and the baby are preparing for the birthing process. These last weeks are vitally important for a mother and her baby, writes Lothian (43). For a first-time mother, the baby often “drops down” into the pelvis in the weeks before birth (Amis 16). This is part of the preparation for labor by the fetus. The last weeks also allow the baby to prepare for his or her entry in the world by allowing the baby to gain weight and strength, store iron, develop more coordinated sucking reflexes and swallowing ability, develop lung maturity further and also allow for important antibodies to be passed on from the mother to the infant (Lothian 44). Also according to Lothian, waiting for labor to begin on its own is the best way to determine if the baby is ready to enter the world and if the mother is ready to begin the birthing process (44).
Normal term labor is the culmination of a sequence of interrelated hormonal shifts that are mediated primarily by the fetus, the placenta, the fetal membranes, and the mother’s endocrine system (Romano and Lothian 94). In an article by Amis, she states that researchers now believe that when a baby is ready for life outside his mother’s uterus, his body releases a tiny amount of a substance that signals the mother’s hormones to begin labor (16). When a woman goes into labor naturally, there are hormones called prostaglandins, which cause the cervix to soften and ripen. The quantity of prostaglandins released increases when the body is ready to deliver the baby (Moran and Kellem, p 32). There are also hormones released that stimulate uterine contractions to begin. According to Romano and Lothian, spontaneous onset of term labor signifies the fetus’ readiness to be born as well as the mother’s physiological receptiveness to the process (94). As the birth approaches, the mother may have a surge of stress hormones that may aid in the birth of the fetus (Romano and Lothian 95). All of these phenomena’s are completely natural and doctors and midwives agree that the natural onset of labor is the best way to deliver the baby.
To define what exactly labor induction is: labor induction is the intentional initiation of uterine contractions before their spontaneous onset. According to ICEA (International Childbirth Education Association), labor induction is a process using various mechanical methods and chemicals to initiate uterine contractions before the onset of spontaneous labor with the goal of accomplishing a successful birth (31). According to Wilson, “an indicated induction is recommended as a therapeutic option when the benefits of birth outweigh the risks of continuing the pregnancy, as seen in certain high risk conditions with fetal compromise. Such conditions include eclampsia, preeclampsia (hypertension in the mother that is directly related to the pregnancy), premature rupture of the membranes, and suspected intrauterine fetal growth restriction” (208). Labor may be induced if it is more risky for your baby to remain inside your body than to be born. According to the American College of Obstetrics and Gynecologists, labor may be induced if: you water has broken and labor has not begun; your pregnancy is post term (more than 42 weeks), you have high blood pressure caused by your pregnancy, you have health problems such as diabetes that could affect your baby, you have an infection in the uterus, your baby is growing too slowly (Amis 16-17).
When labor is brought on artificially, a number of events are not allowed to occur or occur prematurely. When labor is induced artificially, the drug Pitocin (oxytocin) is given intravenously in the hospital setting. Two main functions of prostaglandins are to regulate hormone activity and to contract the smooth muscle of the uterus (ICEA 36). Sometimes drugs called “ripening agents”, such as Cervidil or Cytotec, are given to soften the cervix and prepare it for labor (Amis 17). Pitocin is given after the cervix has ripened (ICEA 37). “Interfering with or replacing the natural hormones that orchestrate labor, birth, breastfeeding, and maternal attachment may have consequences that we do not yet understand,” writes Amis (19).
As with all obstetric conveniences, there is growing evidence that the decision to induce for non-medically necessary reasons increases risks of interventions and complications, including, but not limited to: a longer labor compared to spontaneous labor, artificial rupture of membranes, significant discomfort, epidural anesthesia or increased need of other types of analgesia, maternal fever, hypotension, prolonged second stage of labor, operative vaginal birth, episiotomy, vacuum or forceps assisted vaginal birth, fetal heart changes, shoulder dystocia (where the baby’s shoulder gets stuck behind the mother’s pelvic bones), babies born with low birth weight, need for birth by cesarean section, need for admission to the Neonatal Intensive Care Unit (NICU), jaundice that required treatment and a lengthened hospital stay (Simpson and Thorman 135) (Amis 18) (Romano and Lothian 96). “Medical induction of labor also nearly doubled the risk of overall cases of amniotic-fluid embolism, and the association was stronger for fatal cases” (Kramer et al 1444). Because due dates are not an exact science, and there can be up to a two week error window for the actual due date, a medically induced baby at 38 weeks can actually only be 36 weeks old. This is one of the reasons that babies born after elective induction can have poor outcomes such as low birth weight or jaundice requiring treatment. They were accidentally born before they have reached full maturity, which is defined as reaching 37 completed weeks (Amis 8).
Besides, adverse maternal outcomes, such as cesarean sections, there are other reasons that might warrant waiting for spontaneous onset of labor, such as the addition of escalating health care expenditures, including additional supply and labor costs, added lengths of hospital stay, and increased neonatal and maternal morbidity and mortality. Delivery with spontaneous onset of labor is significantly lower than the cost of delivering following induction, particularly those ending in a cesarean birth (Wilson 212). There is also the chance that the mother may have to an intravenous line and continuous electronic fetal heart monitoring. In many settings, the mother must stay in bed or very close to the bed, and this does not allow the mother to walk freely or change positions in response to labor contractions, possibly slowing the progress of labor. The mother may be unable to take advantage of a soothing tub bath or a warm shower to ease the pain of labor contractions. Artificially induced contractions often peak sooner and remain intense longer than natural contractions, increasing the mother’s need for pain medication (Amis 8). The afore mentioned natural interventions all help the mother to have an “easier” labor and to help the labor progress along at a natural rate. A tub bath or a warm shower can be relaxing to the mother and may even help with pain distraction. Being artificially induced removes the ability to utilize these techniques, which can lead to an increased need for pain relief in the form of medications.
When it comes to the increased cost that is associated with elective induction of labor, Romano writes that women with induced labors were twice as likely to end up having their baby by cesarean delivery and in addition to this, their baby was more likely to need to be admitted to the Neonatal Intensive Care Unit (NICU). These factors resulted in a significantly high increase in the average cost of labor (53).
The matter of convenience is often brought up as a reason to induce labor artificially. According to Amis, hospitals can provide extra nurses on during shifts when inductions are scheduled, the family can prepare for the birth by making work and family arrangements and the physician can schedule the birth on days and during hours that are convenient for them (17). However, the benefits must be weighed with the risks (Simpson and Thorman 135). What is not convenient about artificial induction is when the induction doesn’t go as planned: for example, the induction does not work and the mother is sent home only to return another day and try again, when there are delays in the hospital and when the induction leads to a cesarean birth, consequently leaving the mother to recover from major abdominal surgery rather than vaginal birth, or if the baby has breathing problems and/or has to be admitted to the Neonatal Intensive Care Unit (NICU) (Amis 17).
What are the alternatives for the impatient healthy mother who wants to induce? Do chemical and mechanical interventions have to be used to bring about labor? No, labor can be induced by natural means, such as sexual intercourse or nipple stimulation. In ICEA’s statement, they state that sexual intercourse and nipple stimulation are natural methods that may help to stimulate contractions and improve the inducibility of the cervix. During the act of intercourse, prostaglandins are released into the bloodstream and may act on the uterus and the cervix. Prostaglandins are also contained in semen and may act directly on the cervix after ejaculation during intercourse. Nipple stimulation increases oxytocin that may also act on the uterus to start contractions (34).
If these methods do not work, and the mother is still considering elective induction when there is not a medically necessary reason, then elective inductions for primiparous (first time) women should be offered with caution, particular for women with advanced maternal age (Wilson 213). Furthermore, studies have indicated that medical procedures, such as “epidural analgesia, induction, augmentation of first stage of labor, instrumental vaginal delivery and emergency caesarean section, and a prolonged labor” were all associated with a negative experience of labor and birth (Waldenstrom et al 22). Kramer writes that the “substantially raised risk in women whose labor was medically induced should be a cause for concern, in view of the increasing tendency for clinicians to induce labor, and especially for routine induction at term or after term” (1448). Both the mother and the practitioner should take all of these things into consideration when making the decision for elective induction. The mother should be fully informed of all the risks and possible complications, as well as the comfort techniques (walking, tub bathes, etc) that a medical induction does not always allow.
Ultimately, waiting for labor to begin on its own increases the likelihood that you will have positive lifelong memories of your birth experience and decrease the possibility of complications for both you and the baby (Amis 6). Though I did not have all of the knowledge that is contained in the paper at that ten-week OB appointment, I knew in my heart that waiting for my baby to be born in her own timing was the best way to go. Instinctually, I felt that inducing my baby when there was no medical reason present was not what was best for her, and for me. Having reviewed the literature in the writing of this paper, along with taking birthing classes and reading various birthing books and non peer-reviewed journal articles, I can now say that my instincts were right on. As for the OB that wanted to induce me, I decided not to continue with her for the duration of my pregnancy and found a midwife who has treated me with much more respect for my wishes, for which I am truly grateful.
Works Cited
Amis, D. "Care practice #1: labor begins on its own." Journal of Perinatal Education 16.3 (June 2007): 16-20. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Amis, D. "Care practices that promote normal birth #1: labor begins on it own... including commentary by Gaskin IM." Journal of Perinatal Education 13.2 (Mar. 2004): 6-10. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
"ICEA position statement and review: induction of labor." International Journal of Childbirth Education 18.1 (Mar. 2003): 31-40. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Kramer, MS, et al. "Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study." Lancet 368.9545 (21 Oct. 2006): 1444- 1448. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Lothian, JA. "Saying "no" to induction." Journal of Perinatal Education 15.2 (Mar. 2006): 43-45. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Moran, DE and Kallam,GB The Gift of Motherhood: Your Personal Journey Through Prepared Childbirth. Customized Communications, Inc: Arlington. 2008.
Romano, AM. "Research summaries for normal birth." Journal of Perinatal Education 15.1 (2006 Winter 2006): 52-55. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Romano, AM, and JA Lothian.. "Promoting, protecting, and supporting normal birth: a look at the evidence." JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing 37.1 (2008 Jan-Feb 2008): 94-105. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Simpson, KR, and KE Thorman.. "Obstetric "conveniences": elective induction of labor, cesarean birth on demand, and other potentially unnecessary interventions." Journal of Perinatal & Neonatal Nursing 19.2 (Apr. 2005): 134-144. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Waldenström, U, et al. "A negative birth experience: prevalence and risk factors in a national sample." Birth: Issues in Perinatal Care 31.1 (Mar. 2004): 17-27. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Wilson, BL. "Assessing the effects of age, gestation, socioeconomic status, and ethnicity on labor inductions." Journal of Nursing Scholarship 39.3 (Sep. 2007): 208-213. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
It was my ten-week pregnancy check up. Being the nervous new-to-be mother, I had a lot of questions for my OB when I went to my appointment. One of many questions asked, and answered, was as follows:
“So at what point in the pregnancy do we start talking about the labor and delivery process?” I was just curious, I looking for answer akin to “Oh, about 30 or 35 weeks”. I’m a planner; I just wanted a time-line for myself to mentally prepare for every step in the pregnancy and birthing process. Instead I got something quite different.
“Well, we’ll probably induce you at thirty-eight weeks, most likely on a Thursday.”
What?!? Induction? What in the world for??? “I don’t really believe in being induced for a non-medically necessary reason . . .” I started timidly, completely taken for surprise. I hadn’t really been prepared to defend myself in such a manner at this point in my pregnancy.
In a very brisk, business-like manner, the doctor replied “It really is best, that way your husband will know ahead of time and can get off work (she nodded her head to my husband who was sitting in the chair next to the exam table), you’ll be able to get a full night’s rest before the baby comes . . .” and she continued to rattle off another half dozen or so reasons of why she wanted to induce me.
I couldn’t believe it, and at the same time that I was forming an argument in my head for every single reason, I felt powerless to respond. I felt as though my beliefs had just been trampled upon. From previous visits and conversations with this doctor, I knew that she and I stood on the same ground on many issues including contraception, natural family planning and God’s presence in the entire process of marital bliss, including conception. And here she was telling me she was going to induce me? I was only ten weeks pregnant; I wasn’t carrying twins, I didn’t have two uteruses or a uterus with a septum, I didn’t have any reason for being high risk and needing to have my labor induced. This OB had delivered three of my good friend’s babies and they all were able to have completely natural labors (without ever mentioning induction). Why did she suddenly say she wanted to induce me? Why didn’t she listen to what I wanted to say about being induced? Aren’t I the one who will have to carry and birth this baby and live with the choices and decisions and consequent life long memories, not her? I left her office that day stunned, disappointed, ignored and bewildered. I knew that I had a lot to think about.
My attributing factor to this news was that she had recently moved into a solo practice, away from a group practice. In a group practice, an OB is freed from being on call twenty-four/seven; an OB in solo practice doesn’t have that luxury. So for strictly business reasons of pure convenience, it is not unusual for an OB in solo practice to try to schedule as many inductions as possible, whether they are medically necessary or not.
I am not saying I am against inducing women into labor; there are certainly a number of reasons where a woman should be induced for her safety and/or the safety of her child. For example, preeclampsia or eclampsia (where the mother’s blood pressure is extremely high due to the baby), if the baby has had their first bowel movement prior to the water breaking and/or prior to being born, being two weeks past the due date (greater than 42 weeks), and the list of reasons goes on. For the purpose of this paper, I would like to explore medical induction of labor and the reasons for and against doing so. Personally, I think that a healthy baby being born to a healthy mother should be able to arrive in their own time and that the convenience of the mother, or especially the doctor, should not come into play at all.
Therefore, to be induced, or not to be induced, that is the question. The answer, ultimately, will depend on the beliefs of the mother, the beliefs of the doctor, and hopefully foremost, the health of the baby and the mother evaluated together. Technology has progressed a long way in our society, which has given many babies a chance at life whereas before the technology existed, they, and mostly likely the mother as well, might have died in labor. Unfortunately our society has taken that technology and used it for a purpose that is not its original intent: personal convenience.
According to Wilson, the onset of labor, once considered a naturally occurring event, has become one of timing, control, and convenience for both obstetrical providers and expectant women, with nearly two thirds of all labor induction in the US now initiated for non-medical reasons (208). Is this the best practice for the baby and the mother? The induction of labor for non-medically necessary reasons is one of the most controversial issues in maternity care in this country today (Amis 16). The National Center for Health Statistics wrote that in 2002, the rate of labor induction in the United States had a 129% increase from 1989, the first year that data on induction was collected (Simpson and Thorman, 135). Wilson writes that because labor induction is a relative new event, data collection was not routinely collected for induction until 1989 (208).
In the last few weeks of pregnancy, the mother’s body and the baby are preparing for the birthing process. These last weeks are vitally important for a mother and her baby, writes Lothian (43). For a first-time mother, the baby often “drops down” into the pelvis in the weeks before birth (Amis 16). This is part of the preparation for labor by the fetus. The last weeks also allow the baby to prepare for his or her entry in the world by allowing the baby to gain weight and strength, store iron, develop more coordinated sucking reflexes and swallowing ability, develop lung maturity further and also allow for important antibodies to be passed on from the mother to the infant (Lothian 44). Also according to Lothian, waiting for labor to begin on its own is the best way to determine if the baby is ready to enter the world and if the mother is ready to begin the birthing process (44).
Normal term labor is the culmination of a sequence of interrelated hormonal shifts that are mediated primarily by the fetus, the placenta, the fetal membranes, and the mother’s endocrine system (Romano and Lothian 94). In an article by Amis, she states that researchers now believe that when a baby is ready for life outside his mother’s uterus, his body releases a tiny amount of a substance that signals the mother’s hormones to begin labor (16). When a woman goes into labor naturally, there are hormones called prostaglandins, which cause the cervix to soften and ripen. The quantity of prostaglandins released increases when the body is ready to deliver the baby (Moran and Kellem, p 32). There are also hormones released that stimulate uterine contractions to begin. According to Romano and Lothian, spontaneous onset of term labor signifies the fetus’ readiness to be born as well as the mother’s physiological receptiveness to the process (94). As the birth approaches, the mother may have a surge of stress hormones that may aid in the birth of the fetus (Romano and Lothian 95). All of these phenomena’s are completely natural and doctors and midwives agree that the natural onset of labor is the best way to deliver the baby.
To define what exactly labor induction is: labor induction is the intentional initiation of uterine contractions before their spontaneous onset. According to ICEA (International Childbirth Education Association), labor induction is a process using various mechanical methods and chemicals to initiate uterine contractions before the onset of spontaneous labor with the goal of accomplishing a successful birth (31). According to Wilson, “an indicated induction is recommended as a therapeutic option when the benefits of birth outweigh the risks of continuing the pregnancy, as seen in certain high risk conditions with fetal compromise. Such conditions include eclampsia, preeclampsia (hypertension in the mother that is directly related to the pregnancy), premature rupture of the membranes, and suspected intrauterine fetal growth restriction” (208). Labor may be induced if it is more risky for your baby to remain inside your body than to be born. According to the American College of Obstetrics and Gynecologists, labor may be induced if: you water has broken and labor has not begun; your pregnancy is post term (more than 42 weeks), you have high blood pressure caused by your pregnancy, you have health problems such as diabetes that could affect your baby, you have an infection in the uterus, your baby is growing too slowly (Amis 16-17).
When labor is brought on artificially, a number of events are not allowed to occur or occur prematurely. When labor is induced artificially, the drug Pitocin (oxytocin) is given intravenously in the hospital setting. Two main functions of prostaglandins are to regulate hormone activity and to contract the smooth muscle of the uterus (ICEA 36). Sometimes drugs called “ripening agents”, such as Cervidil or Cytotec, are given to soften the cervix and prepare it for labor (Amis 17). Pitocin is given after the cervix has ripened (ICEA 37). “Interfering with or replacing the natural hormones that orchestrate labor, birth, breastfeeding, and maternal attachment may have consequences that we do not yet understand,” writes Amis (19).
As with all obstetric conveniences, there is growing evidence that the decision to induce for non-medically necessary reasons increases risks of interventions and complications, including, but not limited to: a longer labor compared to spontaneous labor, artificial rupture of membranes, significant discomfort, epidural anesthesia or increased need of other types of analgesia, maternal fever, hypotension, prolonged second stage of labor, operative vaginal birth, episiotomy, vacuum or forceps assisted vaginal birth, fetal heart changes, shoulder dystocia (where the baby’s shoulder gets stuck behind the mother’s pelvic bones), babies born with low birth weight, need for birth by cesarean section, need for admission to the Neonatal Intensive Care Unit (NICU), jaundice that required treatment and a lengthened hospital stay (Simpson and Thorman 135) (Amis 18) (Romano and Lothian 96). “Medical induction of labor also nearly doubled the risk of overall cases of amniotic-fluid embolism, and the association was stronger for fatal cases” (Kramer et al 1444). Because due dates are not an exact science, and there can be up to a two week error window for the actual due date, a medically induced baby at 38 weeks can actually only be 36 weeks old. This is one of the reasons that babies born after elective induction can have poor outcomes such as low birth weight or jaundice requiring treatment. They were accidentally born before they have reached full maturity, which is defined as reaching 37 completed weeks (Amis 8).
Besides, adverse maternal outcomes, such as cesarean sections, there are other reasons that might warrant waiting for spontaneous onset of labor, such as the addition of escalating health care expenditures, including additional supply and labor costs, added lengths of hospital stay, and increased neonatal and maternal morbidity and mortality. Delivery with spontaneous onset of labor is significantly lower than the cost of delivering following induction, particularly those ending in a cesarean birth (Wilson 212). There is also the chance that the mother may have to an intravenous line and continuous electronic fetal heart monitoring. In many settings, the mother must stay in bed or very close to the bed, and this does not allow the mother to walk freely or change positions in response to labor contractions, possibly slowing the progress of labor. The mother may be unable to take advantage of a soothing tub bath or a warm shower to ease the pain of labor contractions. Artificially induced contractions often peak sooner and remain intense longer than natural contractions, increasing the mother’s need for pain medication (Amis 8). The afore mentioned natural interventions all help the mother to have an “easier” labor and to help the labor progress along at a natural rate. A tub bath or a warm shower can be relaxing to the mother and may even help with pain distraction. Being artificially induced removes the ability to utilize these techniques, which can lead to an increased need for pain relief in the form of medications.
When it comes to the increased cost that is associated with elective induction of labor, Romano writes that women with induced labors were twice as likely to end up having their baby by cesarean delivery and in addition to this, their baby was more likely to need to be admitted to the Neonatal Intensive Care Unit (NICU). These factors resulted in a significantly high increase in the average cost of labor (53).
The matter of convenience is often brought up as a reason to induce labor artificially. According to Amis, hospitals can provide extra nurses on during shifts when inductions are scheduled, the family can prepare for the birth by making work and family arrangements and the physician can schedule the birth on days and during hours that are convenient for them (17). However, the benefits must be weighed with the risks (Simpson and Thorman 135). What is not convenient about artificial induction is when the induction doesn’t go as planned: for example, the induction does not work and the mother is sent home only to return another day and try again, when there are delays in the hospital and when the induction leads to a cesarean birth, consequently leaving the mother to recover from major abdominal surgery rather than vaginal birth, or if the baby has breathing problems and/or has to be admitted to the Neonatal Intensive Care Unit (NICU) (Amis 17).
What are the alternatives for the impatient healthy mother who wants to induce? Do chemical and mechanical interventions have to be used to bring about labor? No, labor can be induced by natural means, such as sexual intercourse or nipple stimulation. In ICEA’s statement, they state that sexual intercourse and nipple stimulation are natural methods that may help to stimulate contractions and improve the inducibility of the cervix. During the act of intercourse, prostaglandins are released into the bloodstream and may act on the uterus and the cervix. Prostaglandins are also contained in semen and may act directly on the cervix after ejaculation during intercourse. Nipple stimulation increases oxytocin that may also act on the uterus to start contractions (34).
If these methods do not work, and the mother is still considering elective induction when there is not a medically necessary reason, then elective inductions for primiparous (first time) women should be offered with caution, particular for women with advanced maternal age (Wilson 213). Furthermore, studies have indicated that medical procedures, such as “epidural analgesia, induction, augmentation of first stage of labor, instrumental vaginal delivery and emergency caesarean section, and a prolonged labor” were all associated with a negative experience of labor and birth (Waldenstrom et al 22). Kramer writes that the “substantially raised risk in women whose labor was medically induced should be a cause for concern, in view of the increasing tendency for clinicians to induce labor, and especially for routine induction at term or after term” (1448). Both the mother and the practitioner should take all of these things into consideration when making the decision for elective induction. The mother should be fully informed of all the risks and possible complications, as well as the comfort techniques (walking, tub bathes, etc) that a medical induction does not always allow.
Ultimately, waiting for labor to begin on its own increases the likelihood that you will have positive lifelong memories of your birth experience and decrease the possibility of complications for both you and the baby (Amis 6). Though I did not have all of the knowledge that is contained in the paper at that ten-week OB appointment, I knew in my heart that waiting for my baby to be born in her own timing was the best way to go. Instinctually, I felt that inducing my baby when there was no medical reason present was not what was best for her, and for me. Having reviewed the literature in the writing of this paper, along with taking birthing classes and reading various birthing books and non peer-reviewed journal articles, I can now say that my instincts were right on. As for the OB that wanted to induce me, I decided not to continue with her for the duration of my pregnancy and found a midwife who has treated me with much more respect for my wishes, for which I am truly grateful.
Works Cited
Amis, D. "Care practice #1: labor begins on its own." Journal of Perinatal Education 16.3 (June 2007): 16-20. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Amis, D. "Care practices that promote normal birth #1: labor begins on it own... including commentary by Gaskin IM." Journal of Perinatal Education 13.2 (Mar. 2004): 6-10. CINAHL with Full Text. EBSCO. 7 Mar. 2009
"ICEA position statement and review: induction of labor." International Journal of Childbirth Education 18.1 (Mar. 2003): 31-40. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Kramer, MS, et al. "Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study." Lancet 368.9545 (21 Oct. 2006): 1444- 1448. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Lothian, JA. "Saying "no" to induction." Journal of Perinatal Education 15.2 (Mar. 2006): 43-45. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Moran, DE and Kallam,GB The Gift of Motherhood: Your Personal Journey Through Prepared Childbirth. Customized Communications, Inc: Arlington. 2008.
Romano, AM. "Research summaries for normal birth." Journal of Perinatal Education 15.1 (2006 Winter 2006): 52-55. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Romano, AM, and JA Lothian.. "Promoting, protecting, and supporting normal birth: a look at the evidence." JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing 37.1 (2008 Jan-Feb 2008): 94-105. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Simpson, KR, and KE Thorman.. "Obstetric "conveniences": elective induction of labor, cesarean birth on demand, and other potentially unnecessary interventions." Journal of Perinatal & Neonatal Nursing 19.2 (Apr. 2005): 134-144. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Waldenström, U, et al. "A negative birth experience: prevalence and risk factors in a national sample." Birth: Issues in Perinatal Care 31.1 (Mar. 2004): 17-27. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Wilson, BL. "Assessing the effects of age, gestation, socioeconomic status, and ethnicity on labor inductions." Journal of Nursing Scholarship 39.3 (Sep. 2007): 208-213. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Wednesday, August 25, 2010
Freebirth FAQ
Fierce Mamas support the choice to freebirth! We have been persecuted for it, sometimes very publicly, so it is essential that we keep talking about it to make sure women understand it as a valid birthing option.
We need audience participation to do this well!! Please post your questions about freebirth in the comment section here. Over the next few days, 3 freebirthing women will answer your questions; we will reassemble the entire thing to create an FAQ here on Fierce Mamas. No question is too big or small, although I will be deleting questions of the disrespectful variety ;)
-Arie
We need audience participation to do this well!! Please post your questions about freebirth in the comment section here. Over the next few days, 3 freebirthing women will answer your questions; we will reassemble the entire thing to create an FAQ here on Fierce Mamas. No question is too big or small, although I will be deleting questions of the disrespectful variety ;)
-Arie
Tuesday, August 10, 2010
Rowan’s Birth Story
by Laurinda Reddig
Two years ago today, I gave birth to a beautiful 8lb 11oz baby girl named Rowan. She never breathed on her own, and lived for just one day, so I never felt up to writing her birth story. Now, with my second daughter Willow asleep on my chest, I will try to write Rowan’s story…
My second pregnancy was much more difficult than the first. We had decided not to find out the gender but everyone thought that since my morning sickness was much worse than with my son, continuing throughout the pregnancy, it was a good chance she was a girl. Unlike my first birth, I had a lot of Braxton Hicks and regular early contractions every evening for weeks before my due date. After the fourth false alarm, we headed back home on Friday morning to wait for the real thing.
When I woke up from a nap on Saturday evening, my due date, I told my 3 year old son Griffin to tell the baby it was time to come out. He did just that, and about 15 minutes later my water broke. We headed to the birth center, stopping for ice cream to share with the midwives. Things progressed slowly, as we watched a movie and enjoyed the ice cream. I perched on a birth ball, crocheting a cocoon for the precious life we awaited.
Once the battery ran out on our laptop the movie was over, so we tried to get things moving. I started walking up and down the stairs, pausing for contractions, and realizing the difference between these and the ones I had been feeling for weeks. As things intensified, I went into the birthing suite to try the tub. After a little while I got a little overheated and decided to get out to go to the bathroom.
As I sat in the bathroom, I suddenly felt my baby drop and engage. My son had also not dropped until I was almost ready to push. But this time was different. I could feel my baby struggling, thumping on my pelvic bone repeatedly. My midwives immediately checked her heart rate and discovered it was erratic. They moved me to the bed, trying all sorts of different uncomfortable positions, but her heart rate did not improve. All of the strange positions flared up my asthma, so they gave me an oxygen tube. Meanwhile, they had called the paramedics who were in the lobby of the building. They checked inside to be sure that the cord was not tight around the baby’s neck and gave me the option to try pushing.
As soon as I was in position on the birth stool, which helped to open the way, the baby’s heart rate went back up. After just 3 or 4 long, hard pushes, our baby was born into the waiting arms of her father who handed her to me. As he handed me this tiny slippery baby, my first thought was to check the gender, a girl. Then I held Rowan to me and realized that she was not breathing.
My midwife immediately gave her oxygen from the tube, and began CPR. As I knelt next to them, still attached by the umbilical cord, my midwife and I saw a spot where the cord appeared to have been kinked at some point. As soon as the cord was cut, the paramedics loaded the gurney with our precious baby. My midwife and one assistant went along to continue CPR, and my husband stayed with them and Rowan.
I was left with the second apprentice midwife and my doula. We were informed that another ambulance was there, “to take mom to be with her baby”. We tried to push the placenta out, but it was not coming, so we went along to the hospital.
When we arrived in the hospital ER, I could not even see my baby. No one would give me any answers. They finally explained that Rowan’s organs were in severe failure, and they needed to cool her body down to slow it down and transport her to a hospital with a NICU for further tests. I was finally able to see Rowan when they wheeled her incubator into my room on her way to the ambulance which would transfer her. She looked so small, connected to so many tubes which were all that were keeping her alive. For a few moments, they opened the incubator so I could hold her cold, motionless hand.
My midwives tried to help me get my placenta out, but after the adrenaline of the situation and the ambulance transfer it may not have been possible. Apparently the OBs upstairs chose not to answer their calls and the ER guy actually asked the midwives if they could help. I was left bleeding in the ER for several hours, nearly passing out more than once. It was also during this time that the ER guy pulled off what was left of the umbilical cord and tossed it out with the rest of the waste, so we will never know exactly what the kink we saw was. It may have been caught when her head engaged, or been a kink that had gradually cut off her oxygen over the course of time, or even an aneurysm at some point. We will never know.
When an OB finally deigned to see me, I was put under full anesthesia for a D&C. When I came to in the recovery room, I choked on the oxygen they shoved into my throat raw from a breathing tube. Again, no one would answer my questions. The nurses would not even look me in the eye. I could not stand their looks of pity, when no one would tell me what was going on.
I was relieved to be greeted by a smiling nurse who brought me to my room and made me as comfortable as she could. I will never forget that nurse. As soon as I was settled into the room I was told that my husband needed to talk to me on the phone. He tried to explain to me what the doctors had said, but it basically meant that they were waiting for me to get there before they took our little Rowan off life support. He also asked if we should bring Griffin to the hospital, but at the time I did not see the point and thought it would scare him. The same kind nurse discovered that they could not send me because the other hospital was short staffed. She offered to drive there on her own to transfer with us so I would not have to wait any longer.
My mother rode in the ambulance with me, feeding me the chocolate chip oatmeal cookies she and my son had made when I first went in to labor. The same recipe we have made during each of my labors. I did not taste the cookies at all. The trip was slow as the bridges were blocked off for a bike race. The paramedic asked if they were waiting for me to make decisions about our baby and I said yes. I actually smiled when they used the sirens to pass the blocked traffic, even though we were not technically an emergency.
I finally arrived at the hospital where my baby was, but I still could not see her. They wheeled me into a postpartum room, complete with nursing gown hanging in the bathroom and large print of a father laying with his baby on his chest, much like the first picture we took of my husband when we came home with our son. I immediately asked them to take the picture down, and noticed that the next time we came back to the room it was gone.
Eventually I was wheeled into the NICU to see my daughter. My family was all there, gathered around our poor baby who lay motionless except for the small movement of her chest from the machines that kept her breathing. The doctor explained again, the second time for my husband and my father. Even if they could repair the damage to her body, at some point her oxygen was cut off too long, damaging her brain too severely for normal functioning.
Once the decision was made, I was wheeled back to my room to eat and rest. As we passed through the postpartum ward, I saw older children there to meet their new siblings. I suddenly realized how important it was for Griffin to come meet her. My sister had had a baby just 4 months before and he had been in the waiting room when her son was born. At three years old, he knew what was supposed to happen, and would be very confused if we just did not come home with a baby. But that is another story*.
When I returned to the NICU they wheeled me into a large closet to choose a handmade quilt to wrap Rowan in. That quilt, and the crocheted afghan she was wrapped in are some of the few things we were able to bring home to remember our baby. Looking through the pile of handmade quilts to choose a bright pink and green one for Rowan, I began to think of how Rowan’s short life could make a difference to other parents going through the same thing. As we prepared to say goodbye to our first born daughter, I was envisioning the Remembering Rowan Project*, donating blankets in her memory.
My husband and I got the chance to bathe our baby, wash her hair, and dress her in a simple white gown. My father played his harp, something beautiful for Rowan to experience during her short life. They removed the tubes pumping oxygen and medicine which was all that kept her body going. They had a large double rocking chair where we sat with Griffin to introduce him to his baby sister and explain why she was not coming home with us. Then he took a walk with his uncle while the rest of the family gathered together to each have a chance to hold her, kiss her, and say goodbye to our precious baby. Then the nurse took her vitals and recorded her time of death.
I had to stay overnight in the hospital after all of the blood loss. As they wheeled me back to my room, it felt so strange to leave our baby in the NICU knowing we would never see her again. They told us we could bring her back to the room with us, but that just seemed creepy. We had already said goodbye. It was only her body and holding it longer would not have brought me any comfort. I am not sure her spirit ever really inhabited that body. I have come to believe that there is a small spark that comes at the moment of birth, seems to me babies would get really bored in there for nine months. Call it the soul or the spirit or whatever. But I have to believe Rowan’s tiny spark just never connected, and instead she is everywhere, in everything.
* Read more about the Remembering Rowan Project and her other crafty ventures on Laurinda's Blog. She also wrote an essay on helping her three year old understand the loss of his sister.
Two years ago today, I gave birth to a beautiful 8lb 11oz baby girl named Rowan. She never breathed on her own, and lived for just one day, so I never felt up to writing her birth story. Now, with my second daughter Willow asleep on my chest, I will try to write Rowan’s story…
My second pregnancy was much more difficult than the first. We had decided not to find out the gender but everyone thought that since my morning sickness was much worse than with my son, continuing throughout the pregnancy, it was a good chance she was a girl. Unlike my first birth, I had a lot of Braxton Hicks and regular early contractions every evening for weeks before my due date. After the fourth false alarm, we headed back home on Friday morning to wait for the real thing.
When I woke up from a nap on Saturday evening, my due date, I told my 3 year old son Griffin to tell the baby it was time to come out. He did just that, and about 15 minutes later my water broke. We headed to the birth center, stopping for ice cream to share with the midwives. Things progressed slowly, as we watched a movie and enjoyed the ice cream. I perched on a birth ball, crocheting a cocoon for the precious life we awaited.
Once the battery ran out on our laptop the movie was over, so we tried to get things moving. I started walking up and down the stairs, pausing for contractions, and realizing the difference between these and the ones I had been feeling for weeks. As things intensified, I went into the birthing suite to try the tub. After a little while I got a little overheated and decided to get out to go to the bathroom.
As I sat in the bathroom, I suddenly felt my baby drop and engage. My son had also not dropped until I was almost ready to push. But this time was different. I could feel my baby struggling, thumping on my pelvic bone repeatedly. My midwives immediately checked her heart rate and discovered it was erratic. They moved me to the bed, trying all sorts of different uncomfortable positions, but her heart rate did not improve. All of the strange positions flared up my asthma, so they gave me an oxygen tube. Meanwhile, they had called the paramedics who were in the lobby of the building. They checked inside to be sure that the cord was not tight around the baby’s neck and gave me the option to try pushing.
As soon as I was in position on the birth stool, which helped to open the way, the baby’s heart rate went back up. After just 3 or 4 long, hard pushes, our baby was born into the waiting arms of her father who handed her to me. As he handed me this tiny slippery baby, my first thought was to check the gender, a girl. Then I held Rowan to me and realized that she was not breathing.
My midwife immediately gave her oxygen from the tube, and began CPR. As I knelt next to them, still attached by the umbilical cord, my midwife and I saw a spot where the cord appeared to have been kinked at some point. As soon as the cord was cut, the paramedics loaded the gurney with our precious baby. My midwife and one assistant went along to continue CPR, and my husband stayed with them and Rowan.
I was left with the second apprentice midwife and my doula. We were informed that another ambulance was there, “to take mom to be with her baby”. We tried to push the placenta out, but it was not coming, so we went along to the hospital.
When we arrived in the hospital ER, I could not even see my baby. No one would give me any answers. They finally explained that Rowan’s organs were in severe failure, and they needed to cool her body down to slow it down and transport her to a hospital with a NICU for further tests. I was finally able to see Rowan when they wheeled her incubator into my room on her way to the ambulance which would transfer her. She looked so small, connected to so many tubes which were all that were keeping her alive. For a few moments, they opened the incubator so I could hold her cold, motionless hand.
My midwives tried to help me get my placenta out, but after the adrenaline of the situation and the ambulance transfer it may not have been possible. Apparently the OBs upstairs chose not to answer their calls and the ER guy actually asked the midwives if they could help. I was left bleeding in the ER for several hours, nearly passing out more than once. It was also during this time that the ER guy pulled off what was left of the umbilical cord and tossed it out with the rest of the waste, so we will never know exactly what the kink we saw was. It may have been caught when her head engaged, or been a kink that had gradually cut off her oxygen over the course of time, or even an aneurysm at some point. We will never know.
When an OB finally deigned to see me, I was put under full anesthesia for a D&C. When I came to in the recovery room, I choked on the oxygen they shoved into my throat raw from a breathing tube. Again, no one would answer my questions. The nurses would not even look me in the eye. I could not stand their looks of pity, when no one would tell me what was going on.
I was relieved to be greeted by a smiling nurse who brought me to my room and made me as comfortable as she could. I will never forget that nurse. As soon as I was settled into the room I was told that my husband needed to talk to me on the phone. He tried to explain to me what the doctors had said, but it basically meant that they were waiting for me to get there before they took our little Rowan off life support. He also asked if we should bring Griffin to the hospital, but at the time I did not see the point and thought it would scare him. The same kind nurse discovered that they could not send me because the other hospital was short staffed. She offered to drive there on her own to transfer with us so I would not have to wait any longer.
My mother rode in the ambulance with me, feeding me the chocolate chip oatmeal cookies she and my son had made when I first went in to labor. The same recipe we have made during each of my labors. I did not taste the cookies at all. The trip was slow as the bridges were blocked off for a bike race. The paramedic asked if they were waiting for me to make decisions about our baby and I said yes. I actually smiled when they used the sirens to pass the blocked traffic, even though we were not technically an emergency.
I finally arrived at the hospital where my baby was, but I still could not see her. They wheeled me into a postpartum room, complete with nursing gown hanging in the bathroom and large print of a father laying with his baby on his chest, much like the first picture we took of my husband when we came home with our son. I immediately asked them to take the picture down, and noticed that the next time we came back to the room it was gone.
Eventually I was wheeled into the NICU to see my daughter. My family was all there, gathered around our poor baby who lay motionless except for the small movement of her chest from the machines that kept her breathing. The doctor explained again, the second time for my husband and my father. Even if they could repair the damage to her body, at some point her oxygen was cut off too long, damaging her brain too severely for normal functioning.
Once the decision was made, I was wheeled back to my room to eat and rest. As we passed through the postpartum ward, I saw older children there to meet their new siblings. I suddenly realized how important it was for Griffin to come meet her. My sister had had a baby just 4 months before and he had been in the waiting room when her son was born. At three years old, he knew what was supposed to happen, and would be very confused if we just did not come home with a baby. But that is another story*.
When I returned to the NICU they wheeled me into a large closet to choose a handmade quilt to wrap Rowan in. That quilt, and the crocheted afghan she was wrapped in are some of the few things we were able to bring home to remember our baby. Looking through the pile of handmade quilts to choose a bright pink and green one for Rowan, I began to think of how Rowan’s short life could make a difference to other parents going through the same thing. As we prepared to say goodbye to our first born daughter, I was envisioning the Remembering Rowan Project*, donating blankets in her memory.
My husband and I got the chance to bathe our baby, wash her hair, and dress her in a simple white gown. My father played his harp, something beautiful for Rowan to experience during her short life. They removed the tubes pumping oxygen and medicine which was all that kept her body going. They had a large double rocking chair where we sat with Griffin to introduce him to his baby sister and explain why she was not coming home with us. Then he took a walk with his uncle while the rest of the family gathered together to each have a chance to hold her, kiss her, and say goodbye to our precious baby. Then the nurse took her vitals and recorded her time of death.
I had to stay overnight in the hospital after all of the blood loss. As they wheeled me back to my room, it felt so strange to leave our baby in the NICU knowing we would never see her again. They told us we could bring her back to the room with us, but that just seemed creepy. We had already said goodbye. It was only her body and holding it longer would not have brought me any comfort. I am not sure her spirit ever really inhabited that body. I have come to believe that there is a small spark that comes at the moment of birth, seems to me babies would get really bored in there for nine months. Call it the soul or the spirit or whatever. But I have to believe Rowan’s tiny spark just never connected, and instead she is everywhere, in everything.
* Read more about the Remembering Rowan Project and her other crafty ventures on Laurinda's Blog. She also wrote an essay on helping her three year old understand the loss of his sister.
Tuesday, August 3, 2010
A Lesson In Security
When I was a freshman in high school, my grandpa died. And as a family we made the 12+ hour car trip to go to the funeral and be a part of the family.
We stayed at my grandma's house. My parents and brothers slept upstairs and I slept downstairs in the livingroom on the couch. One night I woke up to a guy rubbing my leg. Twice. I kicked him. Twice. And then I went upstairs to sleep with my parents.
Yes, as a freshman in high school, I went and slept with my parents. Why? Lots of reasons.
I knew the difference between good touch and bad touch. Not necessarily because I was "told" the difference, but because I grew up with good touch. Lots of it.
Also, I was obviously secure enough in my relationship with my parents that I could, even as a teenager, seek them out in the middle of the night in a strange house because something was wrong.
Why am I telling you this? Because it's important.
Recently one of my facebook friends asked how to get his five-month-old to sleep on his own. My response was that he shouldn't have to sleep on his own. Mom and dad are their children's security. And as they grow older, even if they aren't sleeping with you, you are still their security. And if the roots of security are there, your children, even as teenagers, will know even in the middle of the night in their grogginess that they can come to you if they need to. Period.
I taught high school for four years. Several times each year I had a girl come to me with a boy problem. It's just how it is. But of those several times, I remember a select few and their reactions when I said, "You know you dont' have to . . . " The stunned silence and then the anger that suddenly flooded her face made me cringe. I distinctly remember one storming out of the room, not mad at me, but mad. And another one responded with, "Why didn't anyone tell me that?!"
Things could have been so much different that night when I was sleeping in that livingroom. But I knew that I didn't have to.
No, we did not co-sleep with our parents, but their bed was not off limits. We were always close to our parents, physically and emotionally, and our needs were always met in a timely manner. We knew that we could count on them and it was as simple as that. We were their priority. They were our security.
Before we had children, my husband and I took a vacation and went to the coast for a week. I distinctly remember walking up a path behind a family with two girls who looked to be about age 10 and 13. Both of them were holding hands with their dad on the way up the trail. I remember thinking that is how I wanted it to be when we had our kids.
Now, watching our girls attack their daddy when he gets home and seeing them pile on him to read books every night, I know that they are getting their fill of appropriate touch. And to me, that is one fo the very best ways to build their security and protect them from the realities of this world. They are still little, yes. We do our best to keep them safe. But some day they won't be little any more. And when they are big, I want them to be able to come to us, even in the middle of the night, crawl in bed and feel safe.
Please don't push your children away. They need you. You are their security. They are your priority.
By Heidi Donnelly
We stayed at my grandma's house. My parents and brothers slept upstairs and I slept downstairs in the livingroom on the couch. One night I woke up to a guy rubbing my leg. Twice. I kicked him. Twice. And then I went upstairs to sleep with my parents.
Yes, as a freshman in high school, I went and slept with my parents. Why? Lots of reasons.
I knew the difference between good touch and bad touch. Not necessarily because I was "told" the difference, but because I grew up with good touch. Lots of it.
Also, I was obviously secure enough in my relationship with my parents that I could, even as a teenager, seek them out in the middle of the night in a strange house because something was wrong.
Why am I telling you this? Because it's important.
Recently one of my facebook friends asked how to get his five-month-old to sleep on his own. My response was that he shouldn't have to sleep on his own. Mom and dad are their children's security. And as they grow older, even if they aren't sleeping with you, you are still their security. And if the roots of security are there, your children, even as teenagers, will know even in the middle of the night in their grogginess that they can come to you if they need to. Period.
I taught high school for four years. Several times each year I had a girl come to me with a boy problem. It's just how it is. But of those several times, I remember a select few and their reactions when I said, "You know you dont' have to . . . " The stunned silence and then the anger that suddenly flooded her face made me cringe. I distinctly remember one storming out of the room, not mad at me, but mad. And another one responded with, "Why didn't anyone tell me that?!"
Things could have been so much different that night when I was sleeping in that livingroom. But I knew that I didn't have to.
No, we did not co-sleep with our parents, but their bed was not off limits. We were always close to our parents, physically and emotionally, and our needs were always met in a timely manner. We knew that we could count on them and it was as simple as that. We were their priority. They were our security.
Before we had children, my husband and I took a vacation and went to the coast for a week. I distinctly remember walking up a path behind a family with two girls who looked to be about age 10 and 13. Both of them were holding hands with their dad on the way up the trail. I remember thinking that is how I wanted it to be when we had our kids.
Now, watching our girls attack their daddy when he gets home and seeing them pile on him to read books every night, I know that they are getting their fill of appropriate touch. And to me, that is one fo the very best ways to build their security and protect them from the realities of this world. They are still little, yes. We do our best to keep them safe. But some day they won't be little any more. And when they are big, I want them to be able to come to us, even in the middle of the night, crawl in bed and feel safe.
Please don't push your children away. They need you. You are their security. They are your priority.
By Heidi Donnelly
Wednesday, May 26, 2010
Sometimes, we do not win.
You can fight and be fierce and never surrender your power...and still not win. Sometimes they are stronger, sometimes they have power you do not. Sometimes, they take what is yours from you, without your consent. You still need to fight- we are counting on you. Your children, your partner, your self, are all counting on you. You can be loud, or quiet, you can fight actively or resist passively, whatever suits your heart and the situation.
Our world is one that does not respect the autonomy of women as mothers.
When we are pregnant, we are offered threats and fear tactics. We are not given evidence based health care.
When we are birthing, we are cut- more than 1 in 4 of us are cut. We are threatened with the lives of our babies. We are not given evidence based health care.
Some of us choose midwives, who are threatened by the medical system as well. Increasingly, they cannot provide evidence based care, when they must answer to the traditional standards of care provided by OB/GYNs.
Wishing to avoid those threats, some of us choose freebirth. We are threatened with the removal of our children from our homes. We are punished when we seek appropriate care from mainstream practitioners.
We try to breastfeed our babies- most of us do not succeed in breastfeeding them to recommendation. We struggle to receive proper care in a system that does not want us to nurse our babies.
If any of the above sound extreme, they are. Some of us have great experiences, others are raped, abused, punished, lied to. Some of us go home with no baby, victim of the infant mortality rates. Some of us do not go home, victim of the maternal mortality rates.
As long is it is happening to one, it is happening to us all. It is happening to us all. We need to fight- quietly or loudly, with the weapons we have at hand- the love for our children, our sisters, our friends, our selves.
Our world is one that does not respect the autonomy of women as mothers.
When we are pregnant, we are offered threats and fear tactics. We are not given evidence based health care.
When we are birthing, we are cut- more than 1 in 4 of us are cut. We are threatened with the lives of our babies. We are not given evidence based health care.
Some of us choose midwives, who are threatened by the medical system as well. Increasingly, they cannot provide evidence based care, when they must answer to the traditional standards of care provided by OB/GYNs.
Wishing to avoid those threats, some of us choose freebirth. We are threatened with the removal of our children from our homes. We are punished when we seek appropriate care from mainstream practitioners.
We try to breastfeed our babies- most of us do not succeed in breastfeeding them to recommendation. We struggle to receive proper care in a system that does not want us to nurse our babies.
If any of the above sound extreme, they are. Some of us have great experiences, others are raped, abused, punished, lied to. Some of us go home with no baby, victim of the infant mortality rates. Some of us do not go home, victim of the maternal mortality rates.
As long is it is happening to one, it is happening to us all. It is happening to us all. We need to fight- quietly or loudly, with the weapons we have at hand- the love for our children, our sisters, our friends, our selves.
Wednesday, May 5, 2010
Young Punks.
Punk: A young person, especially a member of a rebellious counterculture group.
Anarchist: It seeks to diminish or even abolish authority in the conduct of human relations.
I am raising punks. Anarchist punks. 3 of them. Maybe more.
The alternative parenting bubble I live in seems to be mostly inhabited by 2 groups- punks (& other alternative types appropriate to the era during which they came of age) & conservative people devout to various religions. Seems like an odd convergence, but it really isn't. We all live outside the largely secular, conformist mainstream that encompasses most of North America. We all believe that mainstream society & culture has more potential to hurt our children than to help them grow safely. We all want better for our families & are finding better, more often than not, on the fringes of society.
The punk scene has always centred around questioning &/or rejecting authority, so it should come as no surprise that as they become parents, those in the counterculture will question & reject the norms around birth & parenting too. Hospital birth? Fuck that. Public school? Fuck that too. And fuck your vaccines, your processed garbage food and your behaviouralist parenting too.
Wow, I sound angry, don't I?! That's because I am. I am angry that in order to birth my babies safely, to feed them in a healthy way, to educate them in a way that respects their individuality, I have to say fuck so much. Really. I am angry that it is so much work. Why do I have to be fierce to protect my kids? You mean society won't do that for me? Hell no, they won't. It is up to me & their dad. So I choose to raise tiny little anarchist punks.
I don't make them share. I don't make them go to school. I don't make them eat junk food that will kill them before their time, making them sick on the way there. I don't subject them to public health policy that I am nowhere near convinced is in their best interest. I don't make them follow rules that don't make sense. I let them choose their own birth day.
I am teaching them to question authority. Yes, even mine. I certainly do say "Because I am your mama & I said so!!" more often than I ever intended to, but I also am ok with them standing up to me. I am fierce, I can get over that. We talk about how to be safe in the world, how to make their own choices & be responsible for those outcomes. I let them fall, cry, hurt. I help them get back up.
I am teaching them that the world is good, despite the negative aspects. I point out how many people love them, how we can always count on friends to be there for us. I make sure our door is always open & that there is always food & drink & friendship to share with anyone who shows up at it.
I am teaching them to rock out- to sing and scream and dance their joys & frustrations loudly enough that the heavens will hear them. I am teaching them to love art, music, the land, everything that holds beauty. I want them to trust the earth we stand on, the plants & animals & people that grow on it. I want them to travel, so they see that our culture, our political system, our way of being is not the only one.
I am teaching them to take care of themselves. To eat, sleep, make good food from scratch, to move their bodies as much as they need. I want them to care for their souls by having integrity. I want them to be intuitive, spiritual beings who know God. Whoever that is. I want them to love; themselves & others.
I want them to stand up, to speak up, when they see something wrong. I want them to say "shut up" when they hear bigotry, to say "fuck that" when they see violence. I want them to always be willing to help those being marginalised. I want them to know they are perfect beings worthy of everything good this life has to offer them. I want to empower them to take it if no one is giving that to them.
I am raising punks. Maybe you should too.
By Arie Brentnall-Compton
Anarchist: It seeks to diminish or even abolish authority in the conduct of human relations.
I am raising punks. Anarchist punks. 3 of them. Maybe more.
The alternative parenting bubble I live in seems to be mostly inhabited by 2 groups- punks (& other alternative types appropriate to the era during which they came of age) & conservative people devout to various religions. Seems like an odd convergence, but it really isn't. We all live outside the largely secular, conformist mainstream that encompasses most of North America. We all believe that mainstream society & culture has more potential to hurt our children than to help them grow safely. We all want better for our families & are finding better, more often than not, on the fringes of society.
The punk scene has always centred around questioning &/or rejecting authority, so it should come as no surprise that as they become parents, those in the counterculture will question & reject the norms around birth & parenting too. Hospital birth? Fuck that. Public school? Fuck that too. And fuck your vaccines, your processed garbage food and your behaviouralist parenting too.
Wow, I sound angry, don't I?! That's because I am. I am angry that in order to birth my babies safely, to feed them in a healthy way, to educate them in a way that respects their individuality, I have to say fuck so much. Really. I am angry that it is so much work. Why do I have to be fierce to protect my kids? You mean society won't do that for me? Hell no, they won't. It is up to me & their dad. So I choose to raise tiny little anarchist punks.
I don't make them share. I don't make them go to school. I don't make them eat junk food that will kill them before their time, making them sick on the way there. I don't subject them to public health policy that I am nowhere near convinced is in their best interest. I don't make them follow rules that don't make sense. I let them choose their own birth day.
I am teaching them to question authority. Yes, even mine. I certainly do say "Because I am your mama & I said so!!" more often than I ever intended to, but I also am ok with them standing up to me. I am fierce, I can get over that. We talk about how to be safe in the world, how to make their own choices & be responsible for those outcomes. I let them fall, cry, hurt. I help them get back up.
I am teaching them that the world is good, despite the negative aspects. I point out how many people love them, how we can always count on friends to be there for us. I make sure our door is always open & that there is always food & drink & friendship to share with anyone who shows up at it.
I am teaching them to rock out- to sing and scream and dance their joys & frustrations loudly enough that the heavens will hear them. I am teaching them to love art, music, the land, everything that holds beauty. I want them to trust the earth we stand on, the plants & animals & people that grow on it. I want them to travel, so they see that our culture, our political system, our way of being is not the only one.
I am teaching them to take care of themselves. To eat, sleep, make good food from scratch, to move their bodies as much as they need. I want them to care for their souls by having integrity. I want them to be intuitive, spiritual beings who know God. Whoever that is. I want them to love; themselves & others.
I want them to stand up, to speak up, when they see something wrong. I want them to say "shut up" when they hear bigotry, to say "fuck that" when they see violence. I want them to always be willing to help those being marginalised. I want them to know they are perfect beings worthy of everything good this life has to offer them. I want to empower them to take it if no one is giving that to them.
I am raising punks. Maybe you should too.
By Arie Brentnall-Compton
Friday, April 23, 2010
How Every Mother Can Improve the U.S. Maternal Mortality Rate
Christine Sheets-Nutile
In January of this year, the Joint Commission issued an alert1 to U.S. hospitals which stated, “trends and evidence suggest that maternal mortality rates may be increasing in the U.S.” The national rate is currently three to five times GREATER than that of European countries.2 Unbelievably, a woman giving birth in the U.S. today has a greater risk of dying than a woman birthing in 40 other countries.2
The Commission (which is the leading health care accreditation and standards group in the United States) went on to state that between 28-50% of maternal deaths were PREVENTABLE. In fact, half of the most common errors were related to post-operative care following caesarean sections.1
Recent reports also show that, in the U.S.,3 rates of both labor induction and c-section are TWICE the World Health Organization’s recommendations.2 As we are seeing, these medical interventions (while common) are not without risk.
Labor induction typically involves the use of synthetic oxytocin. This artificial substitute interferes with a woman’s own oxytocin receptors and can lead to postpartum hemorrhaging, delayed or inhibited bonding with her newborn and difficulty establishing breastfeeding.4 A medically induced labor also significantly increases a woman's chances of having an unplanned c-section.5
The risk of a mother’s death after a c-section is more than three times greater than a mother who gave birth vaginally.6 Over a 10 year period, California had a 50% increase in c-sections AND a 50% increase in maternal mortality.7
A Climate of Coercion
The current mainstream birth culture in the U.S. is simply appalling. Pregnancy and birth are treated as a disease and acute trauma-waiting-to-happen. Many women are not given complete information about the birth process. More and more cases are being reported of maternity patients being coerced into submission; their basic human rights are ignored or even revoked through the courts.
Serious medical interventions are presented as a matter of course and focus exclusively on the expected benefits. Risks and adverse effects are usually not even acknowledged! The provider states whatever he or she believes will result in the mother's compliance with the provider’s desired course of action.8
According to “Evidence-Based Maternity Care” (Sakala and Corry), a truly informed choice “requires access to a range of options, good understanding of best evidence about benefits and harms of offered care and of alternatives and solid support for the choices women make.” This rarely occurs among U.S. maternity patients. 4
In a 2009 interview, Dr. Debra Bingham, Executive Director for the California Maternal Quality Care Collaborative and a member of a Maternal Mortality Review Committee, told Amnesty International that the process of gaining an obstetric patient’s consent is highly variable and can depend on who provides information, what information is shared, and how that information is presented to a pregnant woman. “For example, someone who will benefit financially from the woman’s decision may provide information differently than someone who is not financially affected by her decision. Currently, there is limited documentation on what information is shared, how and by whom.”9
Astonishingly, this behavior is not limited to maternal care providers for disadvantaged, low-income or uneducated women. Time and time again, I’ve seen high-powered, confident, educated women become completely submissive. They forgo asking questions and just trust their doctors to make decisions for them, and then accept whatever course of treatment may result.
The Alternative Birth Movement (or What’s “Normal” for the Rest of the World)
83% of women in the U.S. have low-risk pregnancies.10 In most countries, these low-risk women would receive their maternal care from midwives or family practice physicians and often give birth at home. Outside of the U.S., the goal is to minimize risks and maximize good outcomes for mothers and babies, rather than maximize income for a provider and facility. So most obstetricians limit their practice to treating women with high-risk pregnancies and those who develop unexpected complications.11 Ironically, many OB’s in the U.S. no longer have the aptitude or knowledge possessed by their predecessors for such uncommon procedures as: external version to manually turn a baby, vaginal breech birth or vaginal birth of twins.4
It’s interesting to note that groups of maternal care providers identify their roles very differently. OB’s feel it is their responsibility to actively manage childbirth. Midwives and other physicians perceive their function to be facilitators in the birthing process.12 This fundamental distinction is evidenced in the care and treatment of their patients: 4 Midwives possess more hands-on skills and are better able to support a woman in labor and assist her during birth than OB’s; midwives use medical intervention more judiciously than OB’s; and midwives understand that a woman’s individual mind-set, desires and personal history play an important part in her birth, while OB’s deny these influences. 12
In low risk situations, intervention can, in fact, actually impede the birthing process and create those life or death situations that doctors claim to be trying to avoid. Despite their lengthy and expensive educations, far too many U.S. care providers have little or NO experience in observing a normal, natural birth. Therefore, they have no idea what a normal birth looks like, much less what a woman in that situation may need.
Not surprisingly, across the nation, low-risk women and their babies have better outcomes when attended by a midwife, rather than an OB.4, 8
Loss of Faith, Rise of Fear
In contrast to the rest of the world, almost all pregnant women in the U.S. choose to receive their care from an OB and give birth in a hospital. When it's truly needed, medical intervention can, of course, mean the difference between life and death.
But women’s bodies are designed to give birth -- without any interference! It’s only been in the past 100 years13, that birth was appropriated from women and transformed into a paternalistic, medical, mechanized event.14 As such, women lost the knowledge that comes from witnessing and assisting their mothers and sisters give birth. And women lost faith in their bodies’ innate abilities.
Today’s mother-to-be has probably heard more birth-related horror stories than she can count. From the time she was a young girl, she may have heard her mother, her aunts, and even her friends discuss childbirth as a painful, frightening injury. Unfortunately, these misconceptions are perpetuated and reinforced through popular culture of television and movies. In reality, a normal birth wouldn’t bring in big ratings or box-office dollars.
Follow the Money
The U.S. spends more on health care than any other country.15 And more money is spent on maternal health than ANY other form of hospital care.8 Unfortunately, the majority of OB policies, routine procedures and official recommendations are woefully out of date in regards to evidence-based care.4
Outside of the U.S., hospitals typically have a variety of low-tech equipment to aid a woman giving birth – tubs, birthing balls, robes, birthing stools, squatting bars, etc. Any of these can help make birth safer and more comfortable. Unfortunately, very few U.S. hospitals can offer anything besides pharmaceuticals. For the hospital administrator, a birth free of medical interventions is a lost billing opportunity.11
The vast majority of births do NOT require any intervention; but 50-80% of births in U.S. hospitals have AT LEAST one. In reality, any one of these procedures is truly medically necessary in fewer than 20% of all births.8 Ergo between 30-60% of women giving birth in U.S. hospitals are having unnecessary medical procedures performed upon them! But, necessary or not, all of these medical procedures and interventions allow physicians to maximize their billing opportunities.11
In some parts of the country, it’s extremely difficult to find a provider willing to intervene ONLY when truly medically necessary -- especially if the woman has had a previous c-section. Fewer and fewer facilities are willing to accept VBAC (Vaginal Birth After Cesarean) patients.
After years of increased c-sections, most hospitals have reconfigured their maternity units to accommodate more surgical deliveries: more services scheduled during weekday hours, and more post partum beds – needed for the longer stays required after c-sections. These changes required costly capital investments. Now administrators need to see a return on those investments. So it’s not surprising that hospital policies reflect the facility’s increased dependence on the revenue generated by c-sections. After all, a c-section brings in TWICE the revenue of a vaginal birth.4 A surgical birth is also easier on the doctor. It takes less time and is much more predictable than a normal labor and delivery.
For years, the medical establishment has been working to limit birthing options. They've fought against birthing centers, homebirth, midwives, even against their own accountability.
Many believe that they’re more interested in protecting their revenues than improving outcomes for our mothers and babies.11
Rather than abolishing choices, vilifying alternatives and criminalizing their competition, I'd prefer to see them working for other, more worthy goals – such as educating their patients, encouraging normal/natural births and working with facilities to update protocols to reflect evidence-based medicine, all of which will ultimately reduce maternal mortality.
Until then, it’s up to us to change the birth culture!
Improve Your Own Chances of Survival
If you are pregnant or planning to become pregnant:
* Examine your pre-conceived ideas on birth. How were these formed? From stories of women of previous generations? From fictional or sensationalized movies and tv shows? YouTube is awash with amazing, joyous videos of women experiencing normal, natural births. Use these to visualize the kind of birth YOU want.
* Take responsibility for your own education on birth! While pregnant, you have months to prepare and can seek out accurate, complete information. Labor is a time of extreme, internal focus. It would be difficult to absorb and comprehend a significant amount of new information. So preparation is key, in case you need to make decisions quickly. Research common interventions such as: ultrasounds, fetal monitoring, induction of labor, epidurals, extractions and c-sections. Learn the risks and what factors determine when each may truly become necessary. Insist that your provider obtain informed consent for each procedure.
* Read books on natural birthing options. Consider alternatives to the standard OB-attended hospital birth. Choosing a high-tech OB at a high-tech hospital doesn’t guarantee you a safe birth. But it WILL increase your risk for high-tech interventions which may or may not be medically necessary.16 Certified Nurse Midwives (CNM’s) are licensed in all 50 states and can attend births in hospitals, birth centers or even your home. Don’t be afraid to make an unusual choice when it comes to what’s best for you and your baby!
* Don’t choose your provider or facility simply based on location or insurance coverage. Seek out like-minded mothers and local doulas and get their recommendations.
* Schedule a consultation with potential providers before committing to one. Get their rates of various interventions – fetal monitoring, inductions, episiotomies, forcep delivery, vacuum extraction and c-sections. Ask how much freedom you’ll have during labor – particularly on movement, eating/drinking and positioning for birth. Are there limitations on who is allowed to attend your birth? If they’re anything less than forthcoming with these answers, find another provider. Tour the facility. Ask questions there as well, specifically regarding their procedures for newborn care, policies on rooming-in and breastfeeding support.
* Listen to your instincts. More women are educating themselves and seeking providers based on their shared philosophies of birth. Unfortunately, medical professionals can also offer the all too familiar “bait-and-switch.” The provider will agree with everything the mother-to-be wants for her birth throughout her pregnancy, but has NO intention of letting the birth happen on those terms. Shockingly, some will even go out of their way to make SURE it doesn’t, regardless of what’s in the best interest of the mother and her baby. So if you have any reservations about your provider or facility, especially if you feel they are patronizing you, don’t be afraid to make a change – no matter how far along you are.
* Surround yourself with others who have had intervention-free births. Listen to their stories. Ignore those who tell you that you won’t be able to handle it.
* Take a childbirth class, preferably one OUTSIDE of a hospital setting. (Too often, classes hosted by the hospital are more about “How to Be a Good Patient.”) Bradley and Hypnobirthing are excellent choices.
* Choose your labor support team wisely. While your partner, family members and friends may want to be present at the birth, consider hiring a doula. She can provide physical and emotional support throughout your pregnancy, birth and post-partum period. She is knowledgeable about the process of birth, familiar with area providers and facilities and can facilitate communication with staff to help you make informed decisions. A woman in labor is vulnerable – both physically and emotionally. A doula can help protect your space and your choices.
Empower yourself to have the birth YOU desire! Birth is a business. As more mothers demand normal, natural births, providers and facilities will be forced to adapt to attract consumers. Reducing unnecessary interventions will lead to healthier mothers and babies!
Christine Sheets Nutile is a mother of three. She was supported by a doula and used Hypnobirthing for each of her midwife-attended hospital births. She is the co-founder of an Attachment Parenting group in the south suburbs of Chicago. She is also an advocate for natural childbirth, breastfeeding, babywearing and home education.
REFERENCES
1 The Joint Commission, Sentinel Event Alert, Issue 44 from January 26, 2010, “Preventing Maternal Death”; available at http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_44.htm
2 WHO, UNICEF and Wellstart International, “Baby-friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care”, 2009; available at http://www.who.int/nutrition/publications/infantfeeding/9789241594967_s1/en/index.html
3 J. A. Martin et al, Centers for Disease Control, Births: “Final Data for 2006”;
National Vital Statistics Reports, Volume 57, Number 7, from January 7, 2009; available at http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_07.pdf
4 C. Sakala and M. P. Corry, “Evidence-Based Maternity Care: What It Is and What It Can Achieve,” Childbirth Connection and the Reforming States Group, 2008, pages 37, 47, 62-67; available at http://www.childbirthconnection.org/pdfs/evidence-based-maternity-care.pdf
5 K. E. Kaufman, “Elective Induction: An Analysis of Economic and Health Consequences”.
6 C. Deneux-Tharaux et al, “Postpartum Maternal Mortality and Cesarean Delivery”, Obstetrics & Gynecology, Volume 108, Number 3, Part 1, September 2006; available at
http://www.acog.org/from_home/publications/green_journal/2006/v108n3p541.pdf and
J. Villar et al, “Maternal and Neonatal Individual Risks and Benefits Associated with Caesarean Delivery: Multicentre Prospective Study”, BMJ, 2007; 335; 1025; page 5; available at
http://www.bmj.com/cgi/reprint/335/7628/1025?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Caesarean+delivery+rates&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
7 California Maternal Quality Care Collaborative, www.cmqcc.org/maternal_mortality and www.cmqcc.org/maternal_disparities
8 R.M. Andrews, “The National Hospital Bill: The Most Expensive Conditions by
Payer, 2006”, Healthcare Cost and Utilization Project, Statistical Brief 59, 2008, page 7;
available at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb59.pdf
9 Amnesty International Publications, “Deadly Delivery: The Maternal Health Care Crisis in the USA”, 2010, page 1 and 79, available at http://www.amnestyusa.org/dignity/pdf/DeadlyDelivery.pdf
10 National Center for Health Statistics. 2006. 2003 Natality Data Set. SETS 2.0, Rev. 805. Vital and Health Statistics. CD-ROM Series 21, Number 17, May.
11 S. Goodman, “Piercing the Veil: The Marginalization of Midwives in the United
States”, Social Science & Medicine, 65, 2007, pp. 610–21; available at
http://www.collegeofmidwives.org/Citations%20or%20text%2002/Marginalizing_NurseMfry_May07.pdf
12 B Reime et al, “Do Maternity Care Provider Groups Have Different Attitudes Towards Birth?” BJOG: An International Journal of Obstetrics & Gynaecology, Volume 111, Issue 12, Pages 1388-1393; available at http://www3.interscience.wiley.com/cgi-bin/fulltext/118813477/HTMLSTART
13 Y. Lapp Cryns, “Homebirth: As Safe as Birth Gets” The Compleat Mother Magazine 1995; available at http://www.compleatmother.com/homebirth/hb_safety.htm
14 J.J. Mathews and K. Zadak, “The Alternative Birth Movement in the United States: History and Current Status”, Women Health, 1991, Volume 17, Number 1, Page 39; available at http://www.ncbi.nlm.nih.gov/pubmed/2048321
15 Organisation for Economic Co-operation and Development, OECD Health Data 2009–
Frequently Requested Data; available at http://www.oecd.org/document/16/0,3343,en_2649_33929_2085200_1_1_1_1,00.html
16 M. Wagner, “Technology in Birth: First Do No Harm”, Midwifery Today, 2000;
available at http://www.midwiferytoday.com/articles/technologyinbirth.asp#sources
In January of this year, the Joint Commission issued an alert1 to U.S. hospitals which stated, “trends and evidence suggest that maternal mortality rates may be increasing in the U.S.” The national rate is currently three to five times GREATER than that of European countries.2 Unbelievably, a woman giving birth in the U.S. today has a greater risk of dying than a woman birthing in 40 other countries.2
The Commission (which is the leading health care accreditation and standards group in the United States) went on to state that between 28-50% of maternal deaths were PREVENTABLE. In fact, half of the most common errors were related to post-operative care following caesarean sections.1
Recent reports also show that, in the U.S.,3 rates of both labor induction and c-section are TWICE the World Health Organization’s recommendations.2 As we are seeing, these medical interventions (while common) are not without risk.
Labor induction typically involves the use of synthetic oxytocin. This artificial substitute interferes with a woman’s own oxytocin receptors and can lead to postpartum hemorrhaging, delayed or inhibited bonding with her newborn and difficulty establishing breastfeeding.4 A medically induced labor also significantly increases a woman's chances of having an unplanned c-section.5
The risk of a mother’s death after a c-section is more than three times greater than a mother who gave birth vaginally.6 Over a 10 year period, California had a 50% increase in c-sections AND a 50% increase in maternal mortality.7
A Climate of Coercion
The current mainstream birth culture in the U.S. is simply appalling. Pregnancy and birth are treated as a disease and acute trauma-waiting-to-happen. Many women are not given complete information about the birth process. More and more cases are being reported of maternity patients being coerced into submission; their basic human rights are ignored or even revoked through the courts.
Serious medical interventions are presented as a matter of course and focus exclusively on the expected benefits. Risks and adverse effects are usually not even acknowledged! The provider states whatever he or she believes will result in the mother's compliance with the provider’s desired course of action.8
According to “Evidence-Based Maternity Care” (Sakala and Corry), a truly informed choice “requires access to a range of options, good understanding of best evidence about benefits and harms of offered care and of alternatives and solid support for the choices women make.” This rarely occurs among U.S. maternity patients. 4
In a 2009 interview, Dr. Debra Bingham, Executive Director for the California Maternal Quality Care Collaborative and a member of a Maternal Mortality Review Committee, told Amnesty International that the process of gaining an obstetric patient’s consent is highly variable and can depend on who provides information, what information is shared, and how that information is presented to a pregnant woman. “For example, someone who will benefit financially from the woman’s decision may provide information differently than someone who is not financially affected by her decision. Currently, there is limited documentation on what information is shared, how and by whom.”9
Astonishingly, this behavior is not limited to maternal care providers for disadvantaged, low-income or uneducated women. Time and time again, I’ve seen high-powered, confident, educated women become completely submissive. They forgo asking questions and just trust their doctors to make decisions for them, and then accept whatever course of treatment may result.
The Alternative Birth Movement (or What’s “Normal” for the Rest of the World)
83% of women in the U.S. have low-risk pregnancies.10 In most countries, these low-risk women would receive their maternal care from midwives or family practice physicians and often give birth at home. Outside of the U.S., the goal is to minimize risks and maximize good outcomes for mothers and babies, rather than maximize income for a provider and facility. So most obstetricians limit their practice to treating women with high-risk pregnancies and those who develop unexpected complications.11 Ironically, many OB’s in the U.S. no longer have the aptitude or knowledge possessed by their predecessors for such uncommon procedures as: external version to manually turn a baby, vaginal breech birth or vaginal birth of twins.4
It’s interesting to note that groups of maternal care providers identify their roles very differently. OB’s feel it is their responsibility to actively manage childbirth. Midwives and other physicians perceive their function to be facilitators in the birthing process.12 This fundamental distinction is evidenced in the care and treatment of their patients: 4 Midwives possess more hands-on skills and are better able to support a woman in labor and assist her during birth than OB’s; midwives use medical intervention more judiciously than OB’s; and midwives understand that a woman’s individual mind-set, desires and personal history play an important part in her birth, while OB’s deny these influences. 12
In low risk situations, intervention can, in fact, actually impede the birthing process and create those life or death situations that doctors claim to be trying to avoid. Despite their lengthy and expensive educations, far too many U.S. care providers have little or NO experience in observing a normal, natural birth. Therefore, they have no idea what a normal birth looks like, much less what a woman in that situation may need.
Not surprisingly, across the nation, low-risk women and their babies have better outcomes when attended by a midwife, rather than an OB.4, 8
Loss of Faith, Rise of Fear
In contrast to the rest of the world, almost all pregnant women in the U.S. choose to receive their care from an OB and give birth in a hospital. When it's truly needed, medical intervention can, of course, mean the difference between life and death.
But women’s bodies are designed to give birth -- without any interference! It’s only been in the past 100 years13, that birth was appropriated from women and transformed into a paternalistic, medical, mechanized event.14 As such, women lost the knowledge that comes from witnessing and assisting their mothers and sisters give birth. And women lost faith in their bodies’ innate abilities.
Today’s mother-to-be has probably heard more birth-related horror stories than she can count. From the time she was a young girl, she may have heard her mother, her aunts, and even her friends discuss childbirth as a painful, frightening injury. Unfortunately, these misconceptions are perpetuated and reinforced through popular culture of television and movies. In reality, a normal birth wouldn’t bring in big ratings or box-office dollars.
Follow the Money
The U.S. spends more on health care than any other country.15 And more money is spent on maternal health than ANY other form of hospital care.8 Unfortunately, the majority of OB policies, routine procedures and official recommendations are woefully out of date in regards to evidence-based care.4
Outside of the U.S., hospitals typically have a variety of low-tech equipment to aid a woman giving birth – tubs, birthing balls, robes, birthing stools, squatting bars, etc. Any of these can help make birth safer and more comfortable. Unfortunately, very few U.S. hospitals can offer anything besides pharmaceuticals. For the hospital administrator, a birth free of medical interventions is a lost billing opportunity.11
The vast majority of births do NOT require any intervention; but 50-80% of births in U.S. hospitals have AT LEAST one. In reality, any one of these procedures is truly medically necessary in fewer than 20% of all births.8 Ergo between 30-60% of women giving birth in U.S. hospitals are having unnecessary medical procedures performed upon them! But, necessary or not, all of these medical procedures and interventions allow physicians to maximize their billing opportunities.11
In some parts of the country, it’s extremely difficult to find a provider willing to intervene ONLY when truly medically necessary -- especially if the woman has had a previous c-section. Fewer and fewer facilities are willing to accept VBAC (Vaginal Birth After Cesarean) patients.
After years of increased c-sections, most hospitals have reconfigured their maternity units to accommodate more surgical deliveries: more services scheduled during weekday hours, and more post partum beds – needed for the longer stays required after c-sections. These changes required costly capital investments. Now administrators need to see a return on those investments. So it’s not surprising that hospital policies reflect the facility’s increased dependence on the revenue generated by c-sections. After all, a c-section brings in TWICE the revenue of a vaginal birth.4 A surgical birth is also easier on the doctor. It takes less time and is much more predictable than a normal labor and delivery.
For years, the medical establishment has been working to limit birthing options. They've fought against birthing centers, homebirth, midwives, even against their own accountability.
Many believe that they’re more interested in protecting their revenues than improving outcomes for our mothers and babies.11
Rather than abolishing choices, vilifying alternatives and criminalizing their competition, I'd prefer to see them working for other, more worthy goals – such as educating their patients, encouraging normal/natural births and working with facilities to update protocols to reflect evidence-based medicine, all of which will ultimately reduce maternal mortality.
Until then, it’s up to us to change the birth culture!
Improve Your Own Chances of Survival
If you are pregnant or planning to become pregnant:
* Examine your pre-conceived ideas on birth. How were these formed? From stories of women of previous generations? From fictional or sensationalized movies and tv shows? YouTube is awash with amazing, joyous videos of women experiencing normal, natural births. Use these to visualize the kind of birth YOU want.
* Take responsibility for your own education on birth! While pregnant, you have months to prepare and can seek out accurate, complete information. Labor is a time of extreme, internal focus. It would be difficult to absorb and comprehend a significant amount of new information. So preparation is key, in case you need to make decisions quickly. Research common interventions such as: ultrasounds, fetal monitoring, induction of labor, epidurals, extractions and c-sections. Learn the risks and what factors determine when each may truly become necessary. Insist that your provider obtain informed consent for each procedure.
* Read books on natural birthing options. Consider alternatives to the standard OB-attended hospital birth. Choosing a high-tech OB at a high-tech hospital doesn’t guarantee you a safe birth. But it WILL increase your risk for high-tech interventions which may or may not be medically necessary.16 Certified Nurse Midwives (CNM’s) are licensed in all 50 states and can attend births in hospitals, birth centers or even your home. Don’t be afraid to make an unusual choice when it comes to what’s best for you and your baby!
* Don’t choose your provider or facility simply based on location or insurance coverage. Seek out like-minded mothers and local doulas and get their recommendations.
* Schedule a consultation with potential providers before committing to one. Get their rates of various interventions – fetal monitoring, inductions, episiotomies, forcep delivery, vacuum extraction and c-sections. Ask how much freedom you’ll have during labor – particularly on movement, eating/drinking and positioning for birth. Are there limitations on who is allowed to attend your birth? If they’re anything less than forthcoming with these answers, find another provider. Tour the facility. Ask questions there as well, specifically regarding their procedures for newborn care, policies on rooming-in and breastfeeding support.
* Listen to your instincts. More women are educating themselves and seeking providers based on their shared philosophies of birth. Unfortunately, medical professionals can also offer the all too familiar “bait-and-switch.” The provider will agree with everything the mother-to-be wants for her birth throughout her pregnancy, but has NO intention of letting the birth happen on those terms. Shockingly, some will even go out of their way to make SURE it doesn’t, regardless of what’s in the best interest of the mother and her baby. So if you have any reservations about your provider or facility, especially if you feel they are patronizing you, don’t be afraid to make a change – no matter how far along you are.
* Surround yourself with others who have had intervention-free births. Listen to their stories. Ignore those who tell you that you won’t be able to handle it.
* Take a childbirth class, preferably one OUTSIDE of a hospital setting. (Too often, classes hosted by the hospital are more about “How to Be a Good Patient.”) Bradley and Hypnobirthing are excellent choices.
* Choose your labor support team wisely. While your partner, family members and friends may want to be present at the birth, consider hiring a doula. She can provide physical and emotional support throughout your pregnancy, birth and post-partum period. She is knowledgeable about the process of birth, familiar with area providers and facilities and can facilitate communication with staff to help you make informed decisions. A woman in labor is vulnerable – both physically and emotionally. A doula can help protect your space and your choices.
Empower yourself to have the birth YOU desire! Birth is a business. As more mothers demand normal, natural births, providers and facilities will be forced to adapt to attract consumers. Reducing unnecessary interventions will lead to healthier mothers and babies!
Christine Sheets Nutile is a mother of three. She was supported by a doula and used Hypnobirthing for each of her midwife-attended hospital births. She is the co-founder of an Attachment Parenting group in the south suburbs of Chicago. She is also an advocate for natural childbirth, breastfeeding, babywearing and home education.
REFERENCES
1 The Joint Commission, Sentinel Event Alert, Issue 44 from January 26, 2010, “Preventing Maternal Death”; available at http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_44.htm
2 WHO, UNICEF and Wellstart International, “Baby-friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care”, 2009; available at http://www.who.int/nutrition/publications/infantfeeding/9789241594967_s1/en/index.html
3 J. A. Martin et al, Centers for Disease Control, Births: “Final Data for 2006”;
National Vital Statistics Reports, Volume 57, Number 7, from January 7, 2009; available at http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_07.pdf
4 C. Sakala and M. P. Corry, “Evidence-Based Maternity Care: What It Is and What It Can Achieve,” Childbirth Connection and the Reforming States Group, 2008, pages 37, 47, 62-67; available at http://www.childbirthconnection.org/pdfs/evidence-based-maternity-care.pdf
5 K. E. Kaufman, “Elective Induction: An Analysis of Economic and Health Consequences”.
6 C. Deneux-Tharaux et al, “Postpartum Maternal Mortality and Cesarean Delivery”, Obstetrics & Gynecology, Volume 108, Number 3, Part 1, September 2006; available at
http://www.acog.org/from_home/publications/green_journal/2006/v108n3p541.pdf and
J. Villar et al, “Maternal and Neonatal Individual Risks and Benefits Associated with Caesarean Delivery: Multicentre Prospective Study”, BMJ, 2007; 335; 1025; page 5; available at
http://www.bmj.com/cgi/reprint/335/7628/1025?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Caesarean+delivery+rates&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
7 California Maternal Quality Care Collaborative, www.cmqcc.org/maternal_mortality and www.cmqcc.org/maternal_disparities
8 R.M. Andrews, “The National Hospital Bill: The Most Expensive Conditions by
Payer, 2006”, Healthcare Cost and Utilization Project, Statistical Brief 59, 2008, page 7;
available at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb59.pdf
9 Amnesty International Publications, “Deadly Delivery: The Maternal Health Care Crisis in the USA”, 2010, page 1 and 79, available at http://www.amnestyusa.org/dignity/pdf/DeadlyDelivery.pdf
10 National Center for Health Statistics. 2006. 2003 Natality Data Set. SETS 2.0, Rev. 805. Vital and Health Statistics. CD-ROM Series 21, Number 17, May.
11 S. Goodman, “Piercing the Veil: The Marginalization of Midwives in the United
States”, Social Science & Medicine, 65, 2007, pp. 610–21; available at
http://www.collegeofmidwives.org/Citations%20or%20text%2002/Marginalizing_NurseMfry_May07.pdf
12 B Reime et al, “Do Maternity Care Provider Groups Have Different Attitudes Towards Birth?” BJOG: An International Journal of Obstetrics & Gynaecology, Volume 111, Issue 12, Pages 1388-1393; available at http://www3.interscience.wiley.com/cgi-bin/fulltext/118813477/HTMLSTART
13 Y. Lapp Cryns, “Homebirth: As Safe as Birth Gets” The Compleat Mother Magazine 1995; available at http://www.compleatmother.com/homebirth/hb_safety.htm
14 J.J. Mathews and K. Zadak, “The Alternative Birth Movement in the United States: History and Current Status”, Women Health, 1991, Volume 17, Number 1, Page 39; available at http://www.ncbi.nlm.nih.gov/pubmed/2048321
15 Organisation for Economic Co-operation and Development, OECD Health Data 2009–
Frequently Requested Data; available at http://www.oecd.org/document/16/0,3343,en_2649_33929_2085200_1_1_1_1,00.html
16 M. Wagner, “Technology in Birth: First Do No Harm”, Midwifery Today, 2000;
available at http://www.midwiferytoday.com/articles/technologyinbirth.asp#sources
Tuesday, March 30, 2010
An Essay on Circumcision
Making recent provincial and international headlines, the topic of male infant circumcision (herein referred to as MIC), brought up in any forum, is considered by some one of the most controversial debates of the century, with personal views ranging from dead set against it to why wouldn’t you. Many say it is a personal decision, but people are now asking whose decision is it: the boy’s or his parents’? According to a Men’s Health article, MIC became popular in the late 1800s after Lewis Sayre, MD claimed it could cure many diseases including epilepsy and TB; MIC soon became routine after John Harvey Kellogg, MD stated it was a successful remedy for masturbation, considered a major problem in those days.
There are many arguments for leaving a baby boy intact and here are four of the most common. First, MIC is a surgery, even though it is routinely done without sedation or local anaesthetic, with surgical side effects including bleeding and severe pain and surgical risks such as infection, various types of deformities and dysfunctions of the penis, and of course, death. Second, MIC frequently interferes with mother-child bonding and early breastfeeding. Third, recent studies, including Taddio’s, have shown it has detrimental effects of the developing brain and alters pain perception, decreasing pain thresholds in circumcised males. Finally, in later life, MIC causes significantly reduced sexual pleasure.
The four of the most common arguments for MIC are as follow. First, religious reasons including the covenant between Abraham and his descendants and God as written in Genesis 17:10-14 are often cited. Second, there are generations-old family traditions where boys are circumcised and the decision is not questioned as to why. Third, there is a belief that MIC results in decreased urinary tract infections, sexually transmitted infections including HIV and penile cancer, which has recently been disproved by newer studies. Finally, there is the thought that if done early enough in life the boy will not feel the pain or remember the procedure.
More and more research is coming out, or becoming public, about circumcision. Since 1975, the Canadian Association of Paediatricians has recommended against routine circumcision. Their US counterpart had taken a lighter approach until 1999 when they too, began recommending against routine MIC. According to the Canadian Paediatric Society's statement on circumcision in 1975 (and restated in 1982, 1989 and again in 1996), there is no medical indication for circumcision during the neonatal period.
Most of the commonly known reasons for routine circumcision are misunderstood or blown out of proportion. For example, the rate of UTI (urinary tract infection) for an intact baby boy is about 7/1000 and for a circumcised baby is about 2/1000. BUT, the rate of complication from the circumcision surgery is 20-30/1000 with 2-3/1000 being serious complications. Approximately 10/1000 circumcised babies need to have the surgery repeated in later life and only 10/1000 intact boys need to be circumcised in later life.
There is also a belief that the boy should look like his peers, but according to recent studies, Canada has a 31.9% circumcision rate, meaning 68.9% of new baby boys are intact. Currently, Alberta is the highest province with approximately 44% circumcised and Nova Scotia is the lowest with only 6%.
One cannot forget that foreskin has a purpose. It is designed to protect the glans, keeping it soft, moist and warm; it protects the boy from UTIs; it provides the extra skin needed for an erection; it reduces friction during sex and it maintains sexual sensitivity. Every circumcised male experiences an estimated 15% decrease in sexual sensitivity.
I am so glad that I am cheap and questioned getting my son circumcised because it cost so much (almost $400 is Alberta after doctors fee and tray fee). This led me to start researching why they charge for it, and, in turn, led me to question it in general. I have found that circumcision is one subject that the more I read and learn, the more against it I become. Therefore, yes, I am very pro-intact, anticircumcision. I intentionally did not use the word uncircumcised in any of my writing because that makes it sound like circumcision is the norm, which it is not. I also had a little difficulty getting in the opposing arguments, because some are no longer backed by fact and I do not want somebody to believe that some of the old arguments are valid.
While this debate rages on, more research is being done in hopes of ending the controversy. In the meantime, many are choosing to delay the procedure until the boy can decide for himself.
Jenkins, Mark. Separated at Birth. Men’s Health, July/August 1998, pages 130-135,163
Taddio, A. et al. Effect of neonatal circumcision on pain responses during vaccination in boys. The Lancet Volume 345, Number 8945: Pages 291-292, 4 February 1995.
Taddio, A. et al. Effect of neonatal circumcision on pain response during subsequent routine vaccination The Lancet, Volume 349, Number 9052: Pages 599-603, March 1, 1997.
Canadian Paediatric Society’s webpage: www.cps.ca
American Paediatric Society’s webpage: www.aap.org
Peaceful Parenting’s webpage: www.drmomma.org,
Circumcision Information and Research Pages: www.cirp.org
By Alicia Farvolden
There are many arguments for leaving a baby boy intact and here are four of the most common. First, MIC is a surgery, even though it is routinely done without sedation or local anaesthetic, with surgical side effects including bleeding and severe pain and surgical risks such as infection, various types of deformities and dysfunctions of the penis, and of course, death. Second, MIC frequently interferes with mother-child bonding and early breastfeeding. Third, recent studies, including Taddio’s, have shown it has detrimental effects of the developing brain and alters pain perception, decreasing pain thresholds in circumcised males. Finally, in later life, MIC causes significantly reduced sexual pleasure.
The four of the most common arguments for MIC are as follow. First, religious reasons including the covenant between Abraham and his descendants and God as written in Genesis 17:10-14 are often cited. Second, there are generations-old family traditions where boys are circumcised and the decision is not questioned as to why. Third, there is a belief that MIC results in decreased urinary tract infections, sexually transmitted infections including HIV and penile cancer, which has recently been disproved by newer studies. Finally, there is the thought that if done early enough in life the boy will not feel the pain or remember the procedure.
More and more research is coming out, or becoming public, about circumcision. Since 1975, the Canadian Association of Paediatricians has recommended against routine circumcision. Their US counterpart had taken a lighter approach until 1999 when they too, began recommending against routine MIC. According to the Canadian Paediatric Society's statement on circumcision in 1975 (and restated in 1982, 1989 and again in 1996), there is no medical indication for circumcision during the neonatal period.
Most of the commonly known reasons for routine circumcision are misunderstood or blown out of proportion. For example, the rate of UTI (urinary tract infection) for an intact baby boy is about 7/1000 and for a circumcised baby is about 2/1000. BUT, the rate of complication from the circumcision surgery is 20-30/1000 with 2-3/1000 being serious complications. Approximately 10/1000 circumcised babies need to have the surgery repeated in later life and only 10/1000 intact boys need to be circumcised in later life.
There is also a belief that the boy should look like his peers, but according to recent studies, Canada has a 31.9% circumcision rate, meaning 68.9% of new baby boys are intact. Currently, Alberta is the highest province with approximately 44% circumcised and Nova Scotia is the lowest with only 6%.
One cannot forget that foreskin has a purpose. It is designed to protect the glans, keeping it soft, moist and warm; it protects the boy from UTIs; it provides the extra skin needed for an erection; it reduces friction during sex and it maintains sexual sensitivity. Every circumcised male experiences an estimated 15% decrease in sexual sensitivity.
I am so glad that I am cheap and questioned getting my son circumcised because it cost so much (almost $400 is Alberta after doctors fee and tray fee). This led me to start researching why they charge for it, and, in turn, led me to question it in general. I have found that circumcision is one subject that the more I read and learn, the more against it I become. Therefore, yes, I am very pro-intact, anticircumcision. I intentionally did not use the word uncircumcised in any of my writing because that makes it sound like circumcision is the norm, which it is not. I also had a little difficulty getting in the opposing arguments, because some are no longer backed by fact and I do not want somebody to believe that some of the old arguments are valid.
While this debate rages on, more research is being done in hopes of ending the controversy. In the meantime, many are choosing to delay the procedure until the boy can decide for himself.
Jenkins, Mark. Separated at Birth. Men’s Health, July/August 1998, pages 130-135,163
Taddio, A. et al. Effect of neonatal circumcision on pain responses during vaccination in boys. The Lancet Volume 345, Number 8945: Pages 291-292, 4 February 1995.
Taddio, A. et al. Effect of neonatal circumcision on pain response during subsequent routine vaccination The Lancet, Volume 349, Number 9052: Pages 599-603, March 1, 1997.
Canadian Paediatric Society’s webpage: www.cps.ca
American Paediatric Society’s webpage: www.aap.org
Peaceful Parenting’s webpage: www.drmomma.org,
Circumcision Information and Research Pages: www.cirp.org
By Alicia Farvolden
Sunday, March 28, 2010
The Start of a Food Revolution
I watched Jamie Oliver's show "Food revolution" on TV the other night. I was shocked and horrified, but frankly not very surprised. Watching the show (and if you haven't yet you should) really made me think about how we (as a culture) feel about our food and what we know about our food. I wasn't at all surprised that the lunch ladies didn't feel that there was anything wrong with serving the kiddos processed chicken nuggets, and when Jamie asked them to read the list of ingredients on the package, the were not at all concerned about the paragraph of ingredients with unpronouncable names. "The first ingredient is chicken, it's fine". One lady said that if it wasn't ok to eat, the government wouldn't serve it to us right? Right.
This is what got me going. We expect the government to stand up for us little guys and protect us from the big bad corporations, but what we are expecting isn't reality. This is just not happening. AT ALL. Not in North America. We are all fools if we sit idly by and expect the government to save us from making choices that are killing us. In the food biz it may be hard to get at good information about the real value of what we are eating, but it is out there. We need to be responsible to ourselves and our families about what we put in our mouths. When we get this information we need to shout it from the roof tops.
This is the challenge. This is what Jamie is trying to do, and this is what I want you to do too. It might be hard, and we might feel regretful or even guilty examining some of the choices we have made in the past, but I feel like this is very necessary because we are KILLING ourselves and our children, and we should be FIGHTING for their health.
"I believe that every child in America has the right to fresh, nutritious school meals, and that every family deserves real, honest, wholesome food. Too many people are being affected by what they eat. It's time for a national revolution. America needs to stand up for better food!" - Jamie Oliver
Makes you think doesn't it? I love that Jamie is starting in the schools, and educating the children who don't even know what a potato is. I myself, being of a certain lactivist bent, wonder if we don't need to address the fact that this lack of real wholesome food starts with babies, how we feed them and how we feel about how we feed them.
So now I'm gonna start shouting. You may want to cover your ears, because it might hurt, but I feel that this is really vitally important.
We cannot ignore the connection between starting our children's lives on ultra processed food from a can and the growing inability to recognize healthy natural foods. A quick google search reveals over 300 referenced journal articles citing the increased risk of obesity associated with feeding artificial baby milks. One meta study published in the International Journal of Obesity finds a conclusive risk of obesity associated with not breastfeeding.
Another thing to consider is that breastmilk changes in taste, dependent on the mother's diet. So a normally fed baby experiences different flavors with each feed, while an artificially fed baby tastes the same processed mixture day after day. Consider the impact of sensitizing our children in this way from birth. It makes sense to me that if we start them off with mass produced unhealthy food from a can, children will have little or no choice to continue their life in this way. Especially if you consider how we feel about it.
"Formula is the same as breast milk" (or the next best thing)
"I was fed that way and I turned out fine." (with your glasses, obesity and asthma?)
It's terrifying to consider that our inability to feed our children NORMALLY as infant translates to an inability for them to eat normally as children. We do need to consider this, so that we can grieve, give our heads a shake and start to shout. Join me.
Lee-Ann Grenier
This is what got me going. We expect the government to stand up for us little guys and protect us from the big bad corporations, but what we are expecting isn't reality. This is just not happening. AT ALL. Not in North America. We are all fools if we sit idly by and expect the government to save us from making choices that are killing us. In the food biz it may be hard to get at good information about the real value of what we are eating, but it is out there. We need to be responsible to ourselves and our families about what we put in our mouths. When we get this information we need to shout it from the roof tops.
This is the challenge. This is what Jamie is trying to do, and this is what I want you to do too. It might be hard, and we might feel regretful or even guilty examining some of the choices we have made in the past, but I feel like this is very necessary because we are KILLING ourselves and our children, and we should be FIGHTING for their health.
"I believe that every child in America has the right to fresh, nutritious school meals, and that every family deserves real, honest, wholesome food. Too many people are being affected by what they eat. It's time for a national revolution. America needs to stand up for better food!" - Jamie Oliver
Makes you think doesn't it? I love that Jamie is starting in the schools, and educating the children who don't even know what a potato is. I myself, being of a certain lactivist bent, wonder if we don't need to address the fact that this lack of real wholesome food starts with babies, how we feed them and how we feel about how we feed them.
So now I'm gonna start shouting. You may want to cover your ears, because it might hurt, but I feel that this is really vitally important.
We cannot ignore the connection between starting our children's lives on ultra processed food from a can and the growing inability to recognize healthy natural foods. A quick google search reveals over 300 referenced journal articles citing the increased risk of obesity associated with feeding artificial baby milks. One meta study published in the International Journal of Obesity finds a conclusive risk of obesity associated with not breastfeeding.
Another thing to consider is that breastmilk changes in taste, dependent on the mother's diet. So a normally fed baby experiences different flavors with each feed, while an artificially fed baby tastes the same processed mixture day after day. Consider the impact of sensitizing our children in this way from birth. It makes sense to me that if we start them off with mass produced unhealthy food from a can, children will have little or no choice to continue their life in this way. Especially if you consider how we feel about it.
"Formula is the same as breast milk" (or the next best thing)
"I was fed that way and I turned out fine." (with your glasses, obesity and asthma?)
It's terrifying to consider that our inability to feed our children NORMALLY as infant translates to an inability for them to eat normally as children. We do need to consider this, so that we can grieve, give our heads a shake and start to shout. Join me.
Lee-Ann Grenier
Monday, March 22, 2010
Hospital Birth?
Just yesterday I was talking to a mom just for a couple minutes. Somehow the conversation turned to childbirth and she said her first baby was an emergency c-section. Her second was a c-section, too. I said something like, "You know you can have a natural birth after a c-section." She got this look of disgust and said, "I know, but I didn't find out until after my second, and then they told me no way." I haven't known this mom for very long, but her story is so familiar. A mom who was told she couldn't have something that she wanted for herself and her baby and felt she had no choice otherwise.
I have avoided for the most part being a mom with that story. Sometimes I think it's luck, but then I consider the decisions I've made along the way that have led to three beautiful, perfect, and natural labor and delivery stories. The decisions seemed small at the time, but in the end, they were of great magnitude. And I'm convinced that most of it had to do with the professionals I chose to help me along the way. I'm also convinced that knowing what I didn't want and listening to my gut also played key roles in my experiences.
I chose to have my babies in the hospital. I chose this because I was confident that I could do it on my terms. The midwife I was seeing for my first baby (the third one I had seen in my first few months of pregnancy because I just wasn't comfortable with the first two) was very supportive of my choices and even advocated for me when the OB wanted to induce me because I was overdue. I called my mom crying when we were told we would need to report to the hospital the next morning for an induction, even after the NST had shown everything was normal. My husband was furious because the OB hadn't even seen me. I resolved that if they felt that strongly about inducing me, they were going to have to come find me with sirens and flashing lights. Then my midwife called me and said, no, we had a plan and she would see me on Tuesday for our appointment.
But I didn't make it on Tuesday. Contractions started early Monday morning and after 11 ½ hours of un-medicated labor, we met our beautiful, perfect little girl. She showed no signs of being nearly two weeks overdue and nursed like a champ from the very beginning. My husband commented that I was much more pleasant while I was in labor than I had been in the weeks leading up to it. And even minutes after our baby girl was born, I remember saying, "I could do that again." (I had to laugh because when I got my charts a few years later, the mother/baby nurse had written that I was confident in my ability to nurse my baby, "maybe too confident?" I nursed that baby without any trouble for 22 months, as well as every baby after that.)
After our first was born, I was honored to be asked to be a friend's birth partner. I went to all the birth classes with her and I remember sitting there thinking that there was so much this nurse was not telling these new parents. I'll never forget the look on her face when I announced that if you are the pregnant woman, you still have a say in what they do to you, whether it's induce you or simply what drugs they put in your body or the tests they want you to take. And the same went for your baby. You can ask questions, ask them to wait, or just plain say no. The nurse was horrified. And I was equally as horrified at how horrified she was. It was like she was going to lose the control she had over that class because I had just told them they had choices.
Two years later, I was pregnant again. And my midwife was fantastic enough to write in my chart that I didn't need a hep-lock during labor (the first time it was just in the way) and that after the baby was born I didn't need pitocin to shrink my uterus since I planned to nurse my newborn. When we checked in, the triage nurse was pretty set on poking me. But after I insisted, she left, came back and announced it was okay. Thank you, midwife, for writing it in my chart.
This time I was in labor for 6 ½ hours before our second beautiful and perfect baby girl was born. During labor everyone was so nice and helpful making it a beautiful experience. My husband was again amazed at how pleasant I was during labor. He was a big advocate and super support during the whole process. And everyone just went with it because it was going so well. I remember at one point feeling as if I was stalling out, and I looked up to see the midwife just sitting in the rocking chair waiting so patiently. Then my water broke and we had a baby soon after that.
By the time I was pregnant with baby number three, our insurance had changed and I needed to find a new provider. I asked around and heard the name of one OB from several people. So I set an appointment and made my list of "I needs". At the first appointment I rattled my list off and he looked at me, smiled a goofy smile and said, "You sound like my wife." I could have hugged him.
My new OB was my best advocate and wrote everything in my chart. Everything from not poking me to my request for the placenta. He approved of all my requests, including the fact that I didn't want to take the glucose test, and I am forever thankful for him.
When I did go into labor and went to the hospital, the nurse looked at me kind of sideways when I told her I didn't want the hep-lock. Then I said, "I'm not a hysterical woman in labor. You can poke me later if you need to." I could tell she was somewhat confused by my statement, but as labor progressed, she was quite verbal with her observations of how the whole experience was unfolding. No, I wasn't hysterical (she actually wrote in my chart that I was "very pleasant") and my husband was super supportive and helpful. I've come to learn that all of these things are very rare in that hospital.
In the end, I went from 7 centimeters to my water breaking in two contractions. The next contraction the baby crowned, and the next contraction she was born-less than four hours after active labor had started. And the nurse who was originally hesitant about my requests got to catch my baby. She was thrilled.
My OB missed it by twenty minutes. I had to giggle when he walked in. "You know," he said with that same goofy grin he had given me at the beginning, "ninety percent of women can give birth at home."
After my baby was born, we suddenly had a room full of people busily doing what they were supposed to do. But one of them was pushing on my tummy in a not-so-gentle manner. Someone must have noticed because my baby's nurse came up to me after that nurse had left and said very gently, "I think I'll just be your nurse, too." I don't know what went down, but I didn't see the not-so-gentle nurse again. And I was thankful for it.
I had caused quite a stir in the birth unit. I got all sorts of questions about what I was going to do with the placenta, questions about babywearing, and comments on how labor and delivery went. Our delivery nurse was so thrilled to be a part of our experience, and I think she was talking to everyone about it. (Three days later when we came in for a post-partum baby and mommy check, they were still talking about us. We also have a picture of baby #3 with the nurse.) They let me walk to the recovery room and even when we were on our way home, they let me wear our baby out the door in my wrap rather than carry her or have her in the car seat, even though they weren't supposed to. I think they liked us.
I'm not saying everyone should have their baby in the hospital. I'm not against birth centers or home birth. What I am saying is that if you know what you want (or at least you know what you don't want), if you are a little picky, a little insistent, and you find the right people, (and you are nice about it in the mean time) chances are that you can have a really great experience giving birth in a hospital if that's where you choose to be. You should not have guilt for changing providers when you are uncomfortable. Yes, there are pregnancies that need special care due to special circumstances, but even then you can insist on what you deem your best educated choice is. And good providers will help and support you along the way and not make you feel that you are a crazy person.
By Heidi Donnelly
I have avoided for the most part being a mom with that story. Sometimes I think it's luck, but then I consider the decisions I've made along the way that have led to three beautiful, perfect, and natural labor and delivery stories. The decisions seemed small at the time, but in the end, they were of great magnitude. And I'm convinced that most of it had to do with the professionals I chose to help me along the way. I'm also convinced that knowing what I didn't want and listening to my gut also played key roles in my experiences.
I chose to have my babies in the hospital. I chose this because I was confident that I could do it on my terms. The midwife I was seeing for my first baby (the third one I had seen in my first few months of pregnancy because I just wasn't comfortable with the first two) was very supportive of my choices and even advocated for me when the OB wanted to induce me because I was overdue. I called my mom crying when we were told we would need to report to the hospital the next morning for an induction, even after the NST had shown everything was normal. My husband was furious because the OB hadn't even seen me. I resolved that if they felt that strongly about inducing me, they were going to have to come find me with sirens and flashing lights. Then my midwife called me and said, no, we had a plan and she would see me on Tuesday for our appointment.
But I didn't make it on Tuesday. Contractions started early Monday morning and after 11 ½ hours of un-medicated labor, we met our beautiful, perfect little girl. She showed no signs of being nearly two weeks overdue and nursed like a champ from the very beginning. My husband commented that I was much more pleasant while I was in labor than I had been in the weeks leading up to it. And even minutes after our baby girl was born, I remember saying, "I could do that again." (I had to laugh because when I got my charts a few years later, the mother/baby nurse had written that I was confident in my ability to nurse my baby, "maybe too confident?" I nursed that baby without any trouble for 22 months, as well as every baby after that.)
After our first was born, I was honored to be asked to be a friend's birth partner. I went to all the birth classes with her and I remember sitting there thinking that there was so much this nurse was not telling these new parents. I'll never forget the look on her face when I announced that if you are the pregnant woman, you still have a say in what they do to you, whether it's induce you or simply what drugs they put in your body or the tests they want you to take. And the same went for your baby. You can ask questions, ask them to wait, or just plain say no. The nurse was horrified. And I was equally as horrified at how horrified she was. It was like she was going to lose the control she had over that class because I had just told them they had choices.
Two years later, I was pregnant again. And my midwife was fantastic enough to write in my chart that I didn't need a hep-lock during labor (the first time it was just in the way) and that after the baby was born I didn't need pitocin to shrink my uterus since I planned to nurse my newborn. When we checked in, the triage nurse was pretty set on poking me. But after I insisted, she left, came back and announced it was okay. Thank you, midwife, for writing it in my chart.
This time I was in labor for 6 ½ hours before our second beautiful and perfect baby girl was born. During labor everyone was so nice and helpful making it a beautiful experience. My husband was again amazed at how pleasant I was during labor. He was a big advocate and super support during the whole process. And everyone just went with it because it was going so well. I remember at one point feeling as if I was stalling out, and I looked up to see the midwife just sitting in the rocking chair waiting so patiently. Then my water broke and we had a baby soon after that.
By the time I was pregnant with baby number three, our insurance had changed and I needed to find a new provider. I asked around and heard the name of one OB from several people. So I set an appointment and made my list of "I needs". At the first appointment I rattled my list off and he looked at me, smiled a goofy smile and said, "You sound like my wife." I could have hugged him.
My new OB was my best advocate and wrote everything in my chart. Everything from not poking me to my request for the placenta. He approved of all my requests, including the fact that I didn't want to take the glucose test, and I am forever thankful for him.
When I did go into labor and went to the hospital, the nurse looked at me kind of sideways when I told her I didn't want the hep-lock. Then I said, "I'm not a hysterical woman in labor. You can poke me later if you need to." I could tell she was somewhat confused by my statement, but as labor progressed, she was quite verbal with her observations of how the whole experience was unfolding. No, I wasn't hysterical (she actually wrote in my chart that I was "very pleasant") and my husband was super supportive and helpful. I've come to learn that all of these things are very rare in that hospital.
In the end, I went from 7 centimeters to my water breaking in two contractions. The next contraction the baby crowned, and the next contraction she was born-less than four hours after active labor had started. And the nurse who was originally hesitant about my requests got to catch my baby. She was thrilled.
My OB missed it by twenty minutes. I had to giggle when he walked in. "You know," he said with that same goofy grin he had given me at the beginning, "ninety percent of women can give birth at home."
After my baby was born, we suddenly had a room full of people busily doing what they were supposed to do. But one of them was pushing on my tummy in a not-so-gentle manner. Someone must have noticed because my baby's nurse came up to me after that nurse had left and said very gently, "I think I'll just be your nurse, too." I don't know what went down, but I didn't see the not-so-gentle nurse again. And I was thankful for it.
I had caused quite a stir in the birth unit. I got all sorts of questions about what I was going to do with the placenta, questions about babywearing, and comments on how labor and delivery went. Our delivery nurse was so thrilled to be a part of our experience, and I think she was talking to everyone about it. (Three days later when we came in for a post-partum baby and mommy check, they were still talking about us. We also have a picture of baby #3 with the nurse.) They let me walk to the recovery room and even when we were on our way home, they let me wear our baby out the door in my wrap rather than carry her or have her in the car seat, even though they weren't supposed to. I think they liked us.
I'm not saying everyone should have their baby in the hospital. I'm not against birth centers or home birth. What I am saying is that if you know what you want (or at least you know what you don't want), if you are a little picky, a little insistent, and you find the right people, (and you are nice about it in the mean time) chances are that you can have a really great experience giving birth in a hospital if that's where you choose to be. You should not have guilt for changing providers when you are uncomfortable. Yes, there are pregnancies that need special care due to special circumstances, but even then you can insist on what you deem your best educated choice is. And good providers will help and support you along the way and not make you feel that you are a crazy person.
By Heidi Donnelly
Monday, March 8, 2010
For International Women's Day: Advocacy vs Encouragement
I am still stunned by many of the comments in response to last week's Let Your Feet Do The Shopping. While many understood the point of Lee-Ann's post, others did not. There seems to be a strong feeling among some lactivists that anything other than gentle persuasion will only harm the cause of breastfeeding. At an individual, mother to mother level, I agree.
BUT...at an activist, changing public perception & policy level, I call bullshit.
Why are we more concerned about the feelings of one store owner who behaved horribly & freaked out than about the feelings of the mothers (dozens? hundreds?)for whom the formula freebies will destroy their breastfeeding relationships? Why are we not raging that a store owner is unknowingly (I give her the benefit of the doubt with this) endangering the lives & health of infants with her freebie? Why do some defend her, instead of getting angry?
2 reasons.
First, because they are concerned about creating change at the individual level. From that perspective, clearly, the battle of the store owner has been lost. More on that concept later.
Second, because deep deep down, most do not really believe that infant formula & the marketing thereof is dangerous. Yes, yes, yes, of course: Breastmilk is best (it isn't. Not even close. It is in fact just normal.), but formula is just fine, really.
If you are harbouring that notion, deep down, let me disavow you of it.
2 things.
Babies are born expecting to be breastfed. If they aren't, they will not develop as they were supposed to. Period. That translates to a 30% increased risk of death (yes, in North America!) when babies are not breastfed. This is in addition to the myriad health problems caused that do not result in death.
Second, infant formula is a consumer product that is at risk of contamination, misproduction, etc, etc etc. Google formula recall if you don't believe me. So babies can be harmed by the not breastfeeding &/or by the formula itself.
Back to idea of change at the individual level.
We need to differentiate between offering dialogue to individual mothers about breastfeeding & large scale activism.
Large scale activism is what Fierce Mamas is engaged in. We want to effect change with public policy & perception both. We believe that only once that has taken place will individuals understand why, even if they have chosen to not breastfeed, it must be supported as policy.
Before I go farther, I want to point out that as individuals, the 3 major contributors to Fierce Mamas are all professionally supporting breastfeeding mothers. We have a total of more than 20 years between us, providing counselling , information & support to thousands in a variety of capacities. We know of what we speak, here.
Large scale activism. What does that mean? It means getting angry, it means forcing political & perceptual change until breastfeeding as a public health initiative is seen in the same light as similar public health concerns. Smoking & seat belt laws are 2 great examples of this, as delved into in The Problem With Breastfeeding by James Akre.
A current example I can think of is with the idea of extended rear facing toddlers in carseats. Study after study has clearly established that toddlers are 5 times safer rear facing in their carseats. Europeans have long known this & seats there are designed for it. Well respected bodies, such as the AAP, recently made recommendations to that effect. Law moves slower than science, though, so in most (if not all) North American jurisdictions, the law is still stuck at requiring rear facing only to 1 year of age.
Those of us early adopters have long kept our children rear facing, going out of our way to track down the few seats with high enough weight limits to allow the practice.
We post the research & recommendations on Facebook, telling everyone we know about the dangers to their children.
It stuns me to see how many responses to those posts can be negative!! "Why are we infantilising toddlers?" "I turned mine forward at a year & they are fine." "If it is so important, why isn't it law?"
The law moves slower than the science.
What moves the law??
We do. Activists, lobbyists, angry people screaming from the rooftops. Protest, in all its forms. Policy does not change unless we demand it so. Perception does not change unless it becomes socially important to agree with the new line of thinking. Both of those concepts require us to speak out.
So we will keep respectfully, kindly & thoughtfully supporting women who do & do not breastfeed. Everyone deserves that consideration & respect.
And we will keep protesting those practices which hurt women & children, especially today, on International Women's Day.
By Arie Brentnall-Compton.
"The fastest way to change society is to mobilize the women of the world."
-Charles Malik
"Well behaved women rarely make history" -Eleanor Roosevelt
"Nobody can make you feel inferior without your permission." -Eleanor Roosevelt
"Women are the real architects of society." -Harriet Beecher Stowe
BUT...at an activist, changing public perception & policy level, I call bullshit.
Why are we more concerned about the feelings of one store owner who behaved horribly & freaked out than about the feelings of the mothers (dozens? hundreds?)for whom the formula freebies will destroy their breastfeeding relationships? Why are we not raging that a store owner is unknowingly (I give her the benefit of the doubt with this) endangering the lives & health of infants with her freebie? Why do some defend her, instead of getting angry?
2 reasons.
First, because they are concerned about creating change at the individual level. From that perspective, clearly, the battle of the store owner has been lost. More on that concept later.
Second, because deep deep down, most do not really believe that infant formula & the marketing thereof is dangerous. Yes, yes, yes, of course: Breastmilk is best (it isn't. Not even close. It is in fact just normal.), but formula is just fine, really.
If you are harbouring that notion, deep down, let me disavow you of it.
2 things.
Babies are born expecting to be breastfed. If they aren't, they will not develop as they were supposed to. Period. That translates to a 30% increased risk of death (yes, in North America!) when babies are not breastfed. This is in addition to the myriad health problems caused that do not result in death.
Second, infant formula is a consumer product that is at risk of contamination, misproduction, etc, etc etc. Google formula recall if you don't believe me. So babies can be harmed by the not breastfeeding &/or by the formula itself.
Back to idea of change at the individual level.
We need to differentiate between offering dialogue to individual mothers about breastfeeding & large scale activism.
Large scale activism is what Fierce Mamas is engaged in. We want to effect change with public policy & perception both. We believe that only once that has taken place will individuals understand why, even if they have chosen to not breastfeed, it must be supported as policy.
Before I go farther, I want to point out that as individuals, the 3 major contributors to Fierce Mamas are all professionally supporting breastfeeding mothers. We have a total of more than 20 years between us, providing counselling , information & support to thousands in a variety of capacities. We know of what we speak, here.
Large scale activism. What does that mean? It means getting angry, it means forcing political & perceptual change until breastfeeding as a public health initiative is seen in the same light as similar public health concerns. Smoking & seat belt laws are 2 great examples of this, as delved into in The Problem With Breastfeeding by James Akre.
A current example I can think of is with the idea of extended rear facing toddlers in carseats. Study after study has clearly established that toddlers are 5 times safer rear facing in their carseats. Europeans have long known this & seats there are designed for it. Well respected bodies, such as the AAP, recently made recommendations to that effect. Law moves slower than science, though, so in most (if not all) North American jurisdictions, the law is still stuck at requiring rear facing only to 1 year of age.
Those of us early adopters have long kept our children rear facing, going out of our way to track down the few seats with high enough weight limits to allow the practice.
We post the research & recommendations on Facebook, telling everyone we know about the dangers to their children.
It stuns me to see how many responses to those posts can be negative!! "Why are we infantilising toddlers?" "I turned mine forward at a year & they are fine." "If it is so important, why isn't it law?"
The law moves slower than the science.
What moves the law??
We do. Activists, lobbyists, angry people screaming from the rooftops. Protest, in all its forms. Policy does not change unless we demand it so. Perception does not change unless it becomes socially important to agree with the new line of thinking. Both of those concepts require us to speak out.
So we will keep respectfully, kindly & thoughtfully supporting women who do & do not breastfeed. Everyone deserves that consideration & respect.
And we will keep protesting those practices which hurt women & children, especially today, on International Women's Day.
By Arie Brentnall-Compton.
"The fastest way to change society is to mobilize the women of the world."
-Charles Malik
"Well behaved women rarely make history" -Eleanor Roosevelt
"Nobody can make you feel inferior without your permission." -Eleanor Roosevelt
"Women are the real architects of society." -Harriet Beecher Stowe
A Breastfeeding Story- with hyperemesis & pregnancy thrown in!
I discovered I was pregnant in January 2004, while I was off work for refusing the flu shot. Shortly after finding out I became very nauseous and vomitted several times a day. I couldn't hold ANYTHING down. As the weeks went by I became more and more sick. I had to go to the ER and was diagnosed with hyperemesis gaviduim. I was given Diclectin. I had to keep increasing until I was taking more than 10 a day. I was sick for seven months.
Then....on my due date I was watching my favourite show, Coronation Street (at 10am), and thought I felt contractions....they felt different than the Braxton Hicks I had experienced for weeks. They increased in intensity and at about 5pm we got ready to meet the midwife at the hospital.
I did not like being poked and proded by the staff at the hospital, including a lab tech coming into the bathroom to take my blood! No privacy. I had to push for a long long time....but at 10:52pm my daughter was born! I don't remember her nursing the first time...the midwife helped her latch on.
Once home she would latch on and fall asleep. On day three my milk came in. I was SO engorged. OUCH. I had overactive letdown and a tonne of milk. My daughter would latch on until letdown and then.....come off screaming....and milk would spray everywhere. Although I had more than enough milk....she lost more than the desired amount of weight in the first week. I was discouraged..some nursing sessions would last an hour, with a lot of screaming from my baby. My midwife was patient and very dedicated to breastfeeding. She suggested block feeding. She would still pull off screaming. So I would pump for 30 seconds and then stop when I let down, letting the milk spray into a towel, then latched on my baby. Sometimes it helped sometimes it didn't. I also fed her breastmilk with a spoon, which she lapped up like a kitten. My midwife gave me a lot of support and encouragement. It took a month of spoon feeding, pumping until letdown and trying to latch to finally start breastfeeding with ease.
When my daughter was almost two, I became pregnant again. I once again had to deal with hyperemesis. I took mega doses of Diclectin again, and was followed by a researcher at Motherisk. They knew I was still nursing and encouraged it. Because of being sick non stop I let my two year nurse alot. And we cuddled alot.
She came to midwives appointments with me and got to check the baby's heartbeat etc. One visit she told the midwife that she knew that mommies scream the babies out!
Two weeks before my due date I went into labour with my second daugther. It was fast and very intense....just over two hours of really active labour. I had a rather unplanned homebirth that was absolutely fantastic! I nursed after and got up to pee and the midwives made my bed for me and I cuddled back in bed with my baby. About four hours after my second baby was born, my first daughter came in the room and said "LOOK SOMEONE BRINGED US A BABY!!!"
I was surprised that when my milk came in my older daughter gave up solid foods totally and nursed with her new sister. Her poop went back to newborn poop. I mentioned this to my midwife and she assured me that she would thrive and that she would eventually go back to solids. And she did.
Most of the time I enjoyed nursing, but....I did get frustrated and said to my older daughter once...why do you like boobie milk so much? She looked at me and said "Mommy, because it tastes like love". That was the answer that made it worth it.
My two girls tandem nursed for just over a year. Then one day my daughter nursed before bed, sat up and said "Mommy this is the very last time I am going to have boobie milk." And it was. Just like that. I let her decide how to celebrate...she picked making chocolate covered strawberries! YUMMY.
I am still nursing her little sister, and have to admit that I am not looking forward to her telling me she is done.....because that will be the end of nursing for me...which makes me a little sad.
By Jen Paisley
Then....on my due date I was watching my favourite show, Coronation Street (at 10am), and thought I felt contractions....they felt different than the Braxton Hicks I had experienced for weeks. They increased in intensity and at about 5pm we got ready to meet the midwife at the hospital.
I did not like being poked and proded by the staff at the hospital, including a lab tech coming into the bathroom to take my blood! No privacy. I had to push for a long long time....but at 10:52pm my daughter was born! I don't remember her nursing the first time...the midwife helped her latch on.
Once home she would latch on and fall asleep. On day three my milk came in. I was SO engorged. OUCH. I had overactive letdown and a tonne of milk. My daughter would latch on until letdown and then.....come off screaming....and milk would spray everywhere. Although I had more than enough milk....she lost more than the desired amount of weight in the first week. I was discouraged..some nursing sessions would last an hour, with a lot of screaming from my baby. My midwife was patient and very dedicated to breastfeeding. She suggested block feeding. She would still pull off screaming. So I would pump for 30 seconds and then stop when I let down, letting the milk spray into a towel, then latched on my baby. Sometimes it helped sometimes it didn't. I also fed her breastmilk with a spoon, which she lapped up like a kitten. My midwife gave me a lot of support and encouragement. It took a month of spoon feeding, pumping until letdown and trying to latch to finally start breastfeeding with ease.
When my daughter was almost two, I became pregnant again. I once again had to deal with hyperemesis. I took mega doses of Diclectin again, and was followed by a researcher at Motherisk. They knew I was still nursing and encouraged it. Because of being sick non stop I let my two year nurse alot. And we cuddled alot.
She came to midwives appointments with me and got to check the baby's heartbeat etc. One visit she told the midwife that she knew that mommies scream the babies out!
Two weeks before my due date I went into labour with my second daugther. It was fast and very intense....just over two hours of really active labour. I had a rather unplanned homebirth that was absolutely fantastic! I nursed after and got up to pee and the midwives made my bed for me and I cuddled back in bed with my baby. About four hours after my second baby was born, my first daughter came in the room and said "LOOK SOMEONE BRINGED US A BABY!!!"
I was surprised that when my milk came in my older daughter gave up solid foods totally and nursed with her new sister. Her poop went back to newborn poop. I mentioned this to my midwife and she assured me that she would thrive and that she would eventually go back to solids. And she did.
Most of the time I enjoyed nursing, but....I did get frustrated and said to my older daughter once...why do you like boobie milk so much? She looked at me and said "Mommy, because it tastes like love". That was the answer that made it worth it.
My two girls tandem nursed for just over a year. Then one day my daughter nursed before bed, sat up and said "Mommy this is the very last time I am going to have boobie milk." And it was. Just like that. I let her decide how to celebrate...she picked making chocolate covered strawberries! YUMMY.
I am still nursing her little sister, and have to admit that I am not looking forward to her telling me she is done.....because that will be the end of nursing for me...which makes me a little sad.
By Jen Paisley
Tuesday, March 2, 2010
Let Your Feet Do the Shopping
I am still so mad that this is hard to write, so bear with me if I get a little ranty. Our family tries really hard to match our values and our spending dollars. Usually this happens quietly; no one might know why I choose one store over another, one brand over the next. Today I had the opportunity to really put my money where my heart was, but it was harder than I had ever expected.
In the small city that I live in there is one locally owned shop that caters to pregnant moms and children. They sell maternity wear, slings, kids’ clothes and shoes. The store is locally owned and has good quality (albeit pricey) stuff. I went in today to get both of my kids some new shoes and see what was on sale.
We shopped for over an hour and found what we needed, plus a little more. I went with the store owner to the till to pay, and noticed a little handwritten sign on the shelf above the till that read “Ask about free samples”. So I did. The owner told me that it was “just cans of Similac, though my little ones couldn’t tolerate it, and a tote bag for the hospital.” With a closer look I noticed that the sign was obscuring a box labeled “seventh month pregnancy pack” with the Ross-Abbott logo on it.
I asked the owner if she knew that handing out free formula samples undermines breastfeeding. She was immediately confrontational, and heatedly told me that she couldn’t breast feed “not a drop” and that it was a choice, and I shouldn’t shove breastfeeding down everyone’s throats. Excuse me?? I blinked and gulped as she continued to ring up my purchase. I jumped right in to the argument, because this formula feeding as choice thing really gets me riled up. IT’S NOT A CHOICE, IT’S A HEALTH DECISION. A choice that should be made with the help of a qualified medical professional, when the mother has been told the full risks of using artificial baby milk.
I told her how a formula fed baby in North America is FIVE time more likely to die in the first five years of life, than its breastfed counterpart. She countered with the “not everyone can breastfeed, I couldn’t”. I told her that I was very sorry that she didn’t have access to good breastfeeding help and a milk bank. And she again accused me of shoving breastfeeding down “everyone’s throat”.
I wanted to throw my purchases on the counter, demand my money back and walk out in a sanctimonious huff. I didn’t though, as I figured that I wouldn’t be able to calmly explain to my kids why Mommy wasn’t buying their nice new stuff. So I walked out of the store, and put my kids in the car. Then I told them what had happened, and how I thought that we should return the stuff and not shop there anymore. My six year-old was surprisingly understanding. He said “I don’t understand why a clothes store needs to give away bottle milk. Don’t they know it hurts babies?” I dropped the kids off, and returned to the store to return our stuff.
I was feeling calmer when I got there. I felt a sense of conviction. I had a plan. The store was thankfully quiet, I didn’t want another scene. The shop owner looked up at me and smiled. I smiled back and said “I was thinking about what you said, and you were right. It IS a choice, and I choose not to shop in your store. I’d like my money back please.” She began to go through my items, again talking about me not shoving breastfeeding down people’s throats. I told her that this had nothing to do with breastfeeding it had to do with her store’s choice to give out free samples and my choice not to support that. “There are a number of lovely shops in the city nearby that don’t undermine womens' health, and I will happily support them from now on.”
I refused to argue with her anymore, and she refused to give me my money back. The things I had bought were on sale, so she’d only give me a store credit. The receipt was ten minutes old! I was floored. My daughter had worn her shoes out of the store (to the car) so they were non-refundable. I backed down, and left, sad and feeling very defeated.
From the start I had only wanted to have an honest conversation with this woman. Instead I was attacked and humiliated because she couldn’t separate how she fed her kids from how she ran her business. So I came home and after the kids were in bed I wrote the store a letter about the WHO code. Then I wrote this.
by Lee-Ann Grenier
In the small city that I live in there is one locally owned shop that caters to pregnant moms and children. They sell maternity wear, slings, kids’ clothes and shoes. The store is locally owned and has good quality (albeit pricey) stuff. I went in today to get both of my kids some new shoes and see what was on sale.
We shopped for over an hour and found what we needed, plus a little more. I went with the store owner to the till to pay, and noticed a little handwritten sign on the shelf above the till that read “Ask about free samples”. So I did. The owner told me that it was “just cans of Similac, though my little ones couldn’t tolerate it, and a tote bag for the hospital.” With a closer look I noticed that the sign was obscuring a box labeled “seventh month pregnancy pack” with the Ross-Abbott logo on it.
I asked the owner if she knew that handing out free formula samples undermines breastfeeding. She was immediately confrontational, and heatedly told me that she couldn’t breast feed “not a drop” and that it was a choice, and I shouldn’t shove breastfeeding down everyone’s throats. Excuse me?? I blinked and gulped as she continued to ring up my purchase. I jumped right in to the argument, because this formula feeding as choice thing really gets me riled up. IT’S NOT A CHOICE, IT’S A HEALTH DECISION. A choice that should be made with the help of a qualified medical professional, when the mother has been told the full risks of using artificial baby milk.
I told her how a formula fed baby in North America is FIVE time more likely to die in the first five years of life, than its breastfed counterpart. She countered with the “not everyone can breastfeed, I couldn’t”. I told her that I was very sorry that she didn’t have access to good breastfeeding help and a milk bank. And she again accused me of shoving breastfeeding down “everyone’s throat”.
I wanted to throw my purchases on the counter, demand my money back and walk out in a sanctimonious huff. I didn’t though, as I figured that I wouldn’t be able to calmly explain to my kids why Mommy wasn’t buying their nice new stuff. So I walked out of the store, and put my kids in the car. Then I told them what had happened, and how I thought that we should return the stuff and not shop there anymore. My six year-old was surprisingly understanding. He said “I don’t understand why a clothes store needs to give away bottle milk. Don’t they know it hurts babies?” I dropped the kids off, and returned to the store to return our stuff.
I was feeling calmer when I got there. I felt a sense of conviction. I had a plan. The store was thankfully quiet, I didn’t want another scene. The shop owner looked up at me and smiled. I smiled back and said “I was thinking about what you said, and you were right. It IS a choice, and I choose not to shop in your store. I’d like my money back please.” She began to go through my items, again talking about me not shoving breastfeeding down people’s throats. I told her that this had nothing to do with breastfeeding it had to do with her store’s choice to give out free samples and my choice not to support that. “There are a number of lovely shops in the city nearby that don’t undermine womens' health, and I will happily support them from now on.”
I refused to argue with her anymore, and she refused to give me my money back. The things I had bought were on sale, so she’d only give me a store credit. The receipt was ten minutes old! I was floored. My daughter had worn her shoes out of the store (to the car) so they were non-refundable. I backed down, and left, sad and feeling very defeated.
From the start I had only wanted to have an honest conversation with this woman. Instead I was attacked and humiliated because she couldn’t separate how she fed her kids from how she ran her business. So I came home and after the kids were in bed I wrote the store a letter about the WHO code. Then I wrote this.
by Lee-Ann Grenier
Monday, March 1, 2010
Coach
My sister Andrea and I took off after work one night to visit the outlet mall and we went into the Coach store. I saw this purse, hanging all by itself as if it were under a spotlight and I thought, “That purse is so me.” I picked up the purse from its perch, peaked inside, caught a glimpse of the price tag and had an immediate change of heart. Well, I would like to think it was immediate but Andrea could tell you that I kept going back and looking again, just in case I misread the price. I didn’t.
I have never been a purse person, or a make up person, or a clothes person. I guess we all have our priorities, and I have never made fashion one of mine. Why shouldn't I have an expensive designer purse and wear make up to work and get my hair colored and my nails done? I hadn’t even given it much thought up until that damn purse made me question who I was.
A lot of the women I work with are very put together, stylish people with shoes for every outfit and a cupboard full of product, maybe that is who I should be too. I have to admit that I have always admired the women who look like they put a lot of time, money and pride into their appearance. I wish I could look like I felt that good about myself. I tend to view myself as more of the frumpy type whose muffin top pretty much rules out the possibility of looking good in anything I wear, so might as well go with the old standby jeans and knit top from Target. Of course I look like an unpopular college student with gray hair who happens to work in a professional office, but there are worse things.
Weighing out the cost of a bimonthly hair cut and color, biweekly manicures; approximately 10 new pairs of shoes, a solid seven or so new trendy outfits, a face full of make up and that god forsaken Coach purse, in black and one in brown of course…and this clearly wasn’t the answer for me.
That purse was seriously starting to antagonize me. How could one overpriced hunk of leather make me feel so inadequate? I was now examining everything about my appearance in relation to that purse and I just didn’t measure up. So I am now clear on the fact that I can not afford to make myself into something that I am not. Well, that makes things a lot easier, that seemed like it would be a lot of work anyway. So if I am not a Coach carrying fashionista, what am I?
If ever there was an event, aside from spotting a coach purse to lust after, that has made me question every bit of who I am, it is the birth of Miss Leila. I now question how I treat my body, how I keep my home, how I contribute to mankind and how I treat the very earth I live in. Now that is one tiny little thing that could made me question everything about myself that the purse didn’t even touch on, you know the non superficial stuff.
Every morning when I wake up I am filled with a mix of two general ideas, 1. I do not want to go to work today, I want to hang out with my baby and frolic and spend money. 2. Please Lord, keep my family safe today I don’t want to wake up from the greatest dream I could have ever imagined.
When I was pregnant with Leila I remember going to work everyday and loving having her there, hanging out in my belly with me all day long. Her kicking and moving was a constant reminder of this wonderful blessing I had in my life. Life was good, Leila and I were inseparable, she never gave me any little baby attitude and childcare was free. What escapes me to this day, nearly 17 months after she was born, was how I managed to never think beyond the moment of her birth and how my life was about to change. There is only one way to put it; motherhood derailed me. I don’t even think I have started to recover yet, but maybe this is something you don’t recover from. My sense of what is important has completely flip flopped. I don’t care about my job, I don’t care about my hair, not that I ever did, all I care about is doing what is best for my child. When things get hard to handle, I can always look up at the picture on my wall of Leila with her crinkly nose smile and her daddy holding her up for the camera and remind myself that I am the luckiest.
In some ways I think I have gotten easier on myself. I still hate that I am overweight, but I now have an appreciation of what my overstuffed body is capable of doing. I single handedly sustained another human being through 9 months of pregnancy and her first year of life (well, unless you could the puree she smeared all over herself from 6-12 months). I still compare myself to other women, but I now I always win, because whatever they may have, they don’t have Cory and they don’t have Leila.
In other ways I am much harder on myself. I feel now even more that I want my life to have meaning, beyond motherhood; I want my child to be proud of her mother. I want to be proud of myself.
I like to think of the Coach incident as a sort of relapse. For a minute there, I forgot who I was in the face of a super cute, overpriced bag whose cost could have supplied diapers to my daughter for about 8 months. I did get a new purse; I like to think that I have two purses. I have a small Hobo style handbag. It is black with a trendy printed lining and strap, made with my own sewing machine. It isn’t exactly Coach, but it still holds all of my things and I feel good about carrying it. The other is a bigger bag. It is a tote style with lots of pockets. One to house my wallet and cell phone, and lots more to hold diapers, wipes, sippy cups and other baby paraphernalia. I feel especially good about carrying that one. I carry it with me whenever I can manage to have my baby along. Of course things are different now that she can’t come to work with me and has learned to throw a very impressive tantrum, but I am still constantly reminded of my blessing as I watch her grow and learn everyday. One of these days I will make her a little purse to match the purse and diaper bag that I made for myself.
By Tricia Coob
I have never been a purse person, or a make up person, or a clothes person. I guess we all have our priorities, and I have never made fashion one of mine. Why shouldn't I have an expensive designer purse and wear make up to work and get my hair colored and my nails done? I hadn’t even given it much thought up until that damn purse made me question who I was.
A lot of the women I work with are very put together, stylish people with shoes for every outfit and a cupboard full of product, maybe that is who I should be too. I have to admit that I have always admired the women who look like they put a lot of time, money and pride into their appearance. I wish I could look like I felt that good about myself. I tend to view myself as more of the frumpy type whose muffin top pretty much rules out the possibility of looking good in anything I wear, so might as well go with the old standby jeans and knit top from Target. Of course I look like an unpopular college student with gray hair who happens to work in a professional office, but there are worse things.
Weighing out the cost of a bimonthly hair cut and color, biweekly manicures; approximately 10 new pairs of shoes, a solid seven or so new trendy outfits, a face full of make up and that god forsaken Coach purse, in black and one in brown of course…and this clearly wasn’t the answer for me.
That purse was seriously starting to antagonize me. How could one overpriced hunk of leather make me feel so inadequate? I was now examining everything about my appearance in relation to that purse and I just didn’t measure up. So I am now clear on the fact that I can not afford to make myself into something that I am not. Well, that makes things a lot easier, that seemed like it would be a lot of work anyway. So if I am not a Coach carrying fashionista, what am I?
If ever there was an event, aside from spotting a coach purse to lust after, that has made me question every bit of who I am, it is the birth of Miss Leila. I now question how I treat my body, how I keep my home, how I contribute to mankind and how I treat the very earth I live in. Now that is one tiny little thing that could made me question everything about myself that the purse didn’t even touch on, you know the non superficial stuff.
Every morning when I wake up I am filled with a mix of two general ideas, 1. I do not want to go to work today, I want to hang out with my baby and frolic and spend money. 2. Please Lord, keep my family safe today I don’t want to wake up from the greatest dream I could have ever imagined.
When I was pregnant with Leila I remember going to work everyday and loving having her there, hanging out in my belly with me all day long. Her kicking and moving was a constant reminder of this wonderful blessing I had in my life. Life was good, Leila and I were inseparable, she never gave me any little baby attitude and childcare was free. What escapes me to this day, nearly 17 months after she was born, was how I managed to never think beyond the moment of her birth and how my life was about to change. There is only one way to put it; motherhood derailed me. I don’t even think I have started to recover yet, but maybe this is something you don’t recover from. My sense of what is important has completely flip flopped. I don’t care about my job, I don’t care about my hair, not that I ever did, all I care about is doing what is best for my child. When things get hard to handle, I can always look up at the picture on my wall of Leila with her crinkly nose smile and her daddy holding her up for the camera and remind myself that I am the luckiest.
In some ways I think I have gotten easier on myself. I still hate that I am overweight, but I now have an appreciation of what my overstuffed body is capable of doing. I single handedly sustained another human being through 9 months of pregnancy and her first year of life (well, unless you could the puree she smeared all over herself from 6-12 months). I still compare myself to other women, but I now I always win, because whatever they may have, they don’t have Cory and they don’t have Leila.
In other ways I am much harder on myself. I feel now even more that I want my life to have meaning, beyond motherhood; I want my child to be proud of her mother. I want to be proud of myself.
I like to think of the Coach incident as a sort of relapse. For a minute there, I forgot who I was in the face of a super cute, overpriced bag whose cost could have supplied diapers to my daughter for about 8 months. I did get a new purse; I like to think that I have two purses. I have a small Hobo style handbag. It is black with a trendy printed lining and strap, made with my own sewing machine. It isn’t exactly Coach, but it still holds all of my things and I feel good about carrying it. The other is a bigger bag. It is a tote style with lots of pockets. One to house my wallet and cell phone, and lots more to hold diapers, wipes, sippy cups and other baby paraphernalia. I feel especially good about carrying that one. I carry it with me whenever I can manage to have my baby along. Of course things are different now that she can’t come to work with me and has learned to throw a very impressive tantrum, but I am still constantly reminded of my blessing as I watch her grow and learn everyday. One of these days I will make her a little purse to match the purse and diaper bag that I made for myself.
By Tricia Coob
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